FIELD TREATMENT OF TRAUMA VICTIMS WITH 7.5% NACL/DEXTRAN

Project: Research project

Project Details

Description

Trauma, the leading cause of death in young Americans and the
most costly of all health problems in the country, kills most often
by either brain injury or hemorrhage. Hemorrhage remains a
problems because, in part, it is almost impossible to replenish
vascular volume early on, in the field, when the patients are first
treated by medical personnel. Adequate volume expansion with
conventional intravenous solutions requires large amounts of fluid,
and it is impossible to infuse adequate amounts through the small
peripheral venous catheters that are mandated by the intensely
vasoconstricted veins of the patient in traumatic shock. An
intravenous fluid that could achieve resuscitation in small
volumes would solve this problem. 7.5% NaCl/6% Dextran 70 may be such a fluid. Hypertonic
NaCl/Dextran solutions dramatically resuscitate animals from
hemorrhagic shock and, in preliminary clinical studies, work well
in patients. The solutions have many attractive features. They
are cheap, easy to store, do not freeze at ambient temperatures,
and do not support bacterial growth. They are effective no
matter how they are administered, whether into a peripheral
artery, a peripheral vein, or a large central vein. They work well
even when given as a bolus, at least in arrested-hemorrhage
animal models. In animal studies they prevent cerebral edema, at
least temporarily, and they might be useful in patients with brain
injuries. And, the solutions achieve resuscitation with remarkably
small volumes. The proposed study will evaluate the use of small volumes (250
ml) of 7.5% NaCl/6% Dextran 70 in the field resuscitation of
severely injured patients. The study will be prospective,
randomized, and double-blinded and will compare the
hypertonic/hyperoncotic solution with a conventionally-used fluid,
lactated Ringer's the main hypothesis to be tested is that field
administration of small volumes of 7.5% NaCl/6% Dextran 70 can
improve blood pressure and survival of these patients during
transport to the emergency room and that it can accomplish these
ends safely. The study will also evaluate if the solution can
decrease the incidence of post-traumatic organ failure and
improve overall survival.
StatusFinished
Effective start/end date3/1/882/28/91

Funding

  • National Institutes of Health
  • National Institutes of Health

ASJC

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

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