Background: Hemorrhagic shock (HS) requires rapid resuscitation; However, the choice of fluids (crystalloid vs. colloid) remains debated regarding their effectiveness in preventing organ injury. This study aims to compare the effects of single Lactated Ringer's (LR) resuscitation versus a combination of LR-Gelatin on liver damage following controlled HS in a rabbit model.

Methods: This experimental study used four groups: Negative Control (KN: no HS and no resuscitation), Positive Control (KP: HS without resuscitation), KP1 (Resuscitation with LR), and KP2 (Resuscitation with LR-Gelatin). Biochemical (ALP, ALT), physiological (heart rate, temperature), and hematological parameters were measured. The novelty of this study lies in the use of an integrated liver histopathology score as the primary endpoint to assess structural damage post-resuscitation, complementing the acute biochemical data.

Results: Biochemical parameters (ALP/ALT) statistically there was no significant difference (p = 0.94; p = 0.77) between times in all shock groups but showed an increasing trend during shock, especially KP (58.33 ± 25.01; 86.67 ± 28.54). HR parameters showed an increase in HR recovery effect after resuscitation KP1; KP2 (181.00±6.00; 184.33±2.89), However, the temperature continued to decrease especially in KP1 (33.57±0.81), while hematology RBC, Hb, and HCT in KP2 showed significant hemodilution (p = 0.01; p = 0.01; p = 0.01) namely 3.26±0.27 106/μL; 5.67±0.59 g/dL; 22.47±1.46%. Statistical analysis showed a significant difference in liver damage scores between groups (p < 0.001), where the RL-Gelatin combination (KP2) significantly reduced damage (Median = 2; IQR = 0.75) compared to the no-resuscitation group (KP) (p = 0.02) to a level that was not significantly different from the negative control (KN) (p = 0.78), confirming that the therapy has the potential to provide a protective effect of gelatin on the structural integrity of hepatocytes, confirmed that gelatin therapy has the potential to provide a protective effect on the structural integrity of hepatocytes.

Conclusion: The combination of LR-Gelatin has the potential to provides superior liver structural protection compared to LR alone.