• Eric Noll, Michele Diana, Anne L Charles, François Singh, Tong J Gan, Julien Pottecher, François-Marie Moussallieh, Izzie J Namer, Bernard Geny, and Pierre Diemunsch.
• From the Anesthesia and Intensive Care, Hôpital de Hautepierre, University Hospitals of Strasbourg (EN, JP, PD), EA 3072, Laboratoire de Physiologie, Fédération de Médecine Translationnelle, Strasbourg University (EN, MD, ALC, FS, JP, BG, PD), IHU-Strasbourg, University Institute for Image-Guided Surgery, Strasbourg, France (EN, MD, JP, PD), Department of Anesthesiology, Stony Brook University, Stony Brook, New York, USA (TJG), Biophysics and Nuclear Medicine, Hôpital de Hautepierre, University Hospitals of Strasbourg (F-MM, IJN) and ICube, University of Strasbourg/CNRS UMR 7357, Strasbourg, France (F-MM, IJN).
• Eur J Anaesthesiol. 2017 Feb 1; 34 (2): 89-97.

BackgroundProtection against acute skeletal muscle metabolic dysfunction and oxidative stress could be a therapeutic target in volume expansion for severely bleeding patients.ObjectivesThis experimental pilot study in swine aims at comparing 130/0.4 hydroxyethyl starch (HES) with 4% albumin along with crystalloid perfusion for first-line volume expansion in haemorrhagic shock with a particular emphasis on oxidative stress and muscular mitochondrial function.DesignRandomised experimental study.SettingDigestive Cancer Research Institute Preclinical Laboratory, Strasbourg University Hospital, France, from February 2012 to June 2013.AnimalsTwenty large white pigs.InterventionPressure-controlled haemorrhagic shock and volume resuscitation using either 4% human serum albumin or 130/0.4 HES along with crystalloid perfusion were performed in 20 large white pigs.Main Outcome MeasuresMuscular biopsy of gastrocnemius muscle was performed for metabolomics screening, mitochondrial respiratory chain assessment and electron spin resonance reactive oxygen species production along with arterial and venous reactive oxygen species production at baseline, at the completion of shock, at 90 min and at 180 min after volume expansion.ResultsThere was no difference between the two groups in measurements of skeletal muscle superoxide production. In a pooled analysis, there was a statistically significant decrease in gastrocnemius muscle creatine content from baseline to 90 min (P < 0.05) and 180 min (P < 0.05). Muscular lactate content and mitochondrial respiratory chain oxidative capacity remained constant at the respective time points.ConclusionIn this pilot experimental study in swine, during pressure-controlled haemorrhagic shock treated with either albumin or 130/0.4 HES in conjunction with crystalloid perfusion, skeletal muscle metabolic profile was unaltered.Ethical Approval Number38.2012.01.031.

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