Resuscitation of severe uncontrolled hemorrhage: 7.5% sodium chloride/6% dextran 70 vs 0.9% sodium chloride
| Autor: | Sharhabeel Jwayyed, Steven C. Dronen, Xu Wang, Susan A. Stern |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Resuscitation
Swine Sodium Hemodynamics chemistry.chemical_element Blood Pressure Hemorrhage Sodium Chloride Medicine Animals Saline Solution Hypertonic Dose-Response Relationship Drug business.industry Dextrans General Medicine Dextran 70 Hypertonic saline Pulse pressure Disease Models Animal chemistry Anesthesia Shock (circulatory) Emergency Medicine Analysis of variance medicine.symptom business |
| Zdroj: | Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 7(8) |
| ISSN: | 1069-6563 |
| Popis: | Objectives: Resuscitation studies of hypertonic saline using controlled and uncontrolled hemorrhage models yield conflicting results with regard to efficacy. These disparate results reflect the use of models and resuscitation regimens that are not comparable between studies. This study evaluated the effects of comparable and clinically relevant resuscitation regimens of 7.5% sodium chloride/6% dextran 70 (HSD) and 0.9% sodium chloride (NS) in a near-fatal uncontrolled hemorrhage model. Methods: Thirty-six swine (14.2 to 21.4 kg) with 4-mm aortic tears were bled to a pulse pressure of 5 mm Hg (40-45 mL/kg). The animals were resuscitated with either NS or HSD administered in volumes that provided equivalent sodium loads at similar rates. Group II (n = 12) was resuscitated with 80 mL/kg of NS at a rate of 4 mL/kg/min. Group III (n = 12) received 9.6 mL/kg of HSD at a rate of 0.48 mL/kg/min. In both groups, crystalloid resuscitation was followed by shed blood infusion (30 mL/kg) at a rate of 2 mL/kg/min. Group I (controls; n = 12) were not resuscitated. Results: One-hour mortality was significantly greater in group I (92%) as compared with group II (33%) and group III (33%) (Fisher's exact test; p = 0.004). Intraperitoneal hemorrhage was significantly greater in group II (34 ± 20 mL/kg) and group III (31 ± 13 mL/kg) as compared with group I (5 ± 2 mL/kg) (ANOVA; p < 0.05). There was no significant difference in hemodynamic parameters between groups II and III. Conclusion: In this model of severe uncontrolled hemorrhage, resuscitation with HSD or NS, administered in volumes that provided equivalent sodium loads at similar rates, had similar effects on mortality, hemodynamic parameters, and hemorrhage from the injury site. |
| Databáze: | OpenAIRE |
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