Link of Video Abstract: https://youtu.be/9qgtSz73eyE
Introduction: Pringle maneuver is the choice of hepatic inflow occlusion, when blood circulation is reopened, reperfusion will occur which causes ischemia/reperfusion injury (IRI) which will result in liver tissue damage. Methylprednisolone injection plays a role in deactivating kupffer thereby preventing inflammatory reactions that will reduce hepatic IRI. This study aims to determine intravenous methylprednisolone's effect on the degree of hepatic ischemia/reperfusion injury in class III hypovolemic shock where continuous clamping was performed.
Methods: Fifteen white rats (Rattus novergicus) underwent laparotomy, aspiration of blood up to 30% of the estimated blood volume (EBV) was carried out to prevent class III hypovolemic shock. The treatment group was given a single dose of 30 mg/kgBW methylprednisolone, while the control group received 30 mg/KgBW 0.9% sodium chloride. Then the Pringle maneuver continuous clamping is performed for up to 30 minutes and resuscitation of the aspirated blood back to the vena cava. On the 5th postoperative day, hepatic biopsy and total bilirubin were examined.
Results: Histopathological examination of the liver parenchyma as assessed by Suzuki's score showed a mean ± SD of the control group (K) 1.40 ± 0.91 while the treatment group (MP) 5.93 ± 1.03 with a p-value of 0.001 < 0.05. Total bilirubin results showed a mean ± SD of the control group (K) 0.21 ± 0.13 while the treatment group (MP) 0.22 ± 0.11 with a p-value of 0.477 > 0.05.
Conclusion: Intravenous methylprednisolone in rats that experienced ischemic/reperfusion injury after continuous clamping in class III hypovolemic shock did not reduce the degree of hepatic parenchymal damage assessed by Suzuki's histopathology score. However, it reduces the total bilirubin value.