Abstract
Using a standardized liver injury model of uncontrolled hemorrhage, we tested the effect of different hypertonic solutions on mortality, blood pressure, intra-abdominal bleeding, and circulating blood volume. After liver injury, rats were randomized to 4 groups: lactated Ringer's (LR, n = 10), Isosal (ISO, n = 10), hypertonic saline (HS, n = 10), and hypertonic sodium acetate (HA, n = 10). In all resuscitation groups, 4 mL/kg was infused at a rate of 0.4 mL/min. Blood volume was evaluated both directly and by estimation. Mortality was highest after HA resuscitation (40%) and lowest after HS resuscitation (0%), but this difference was not significant. Blood pressure was significantly higher after HS resuscitation, and this difference was sustained for 4 hours. The HA resuscitation did not increase blood pressure compared with LR resuscitation. Intraperitoneal blood volume was significantly higher with HS (25.5 ± 0.7 mL/kg) and HA (26.8 ± 1.2 mL/kg) than with LR (22.5 ± 0.4 mL/kg). The HA resuscitation led to a significantly larger drop from baseline values of estimated terminal circulating blood volume than LR resuscitation. Nonparametric analysis combining survival time and directly measured change in blood volume demonstrated a significant advantage to HS, compared with LR. HA and HS resuscitations increased bleeding from uncontrolled solid viscus injury. The HS resuscitation restored blood pressure better than the other hypertonic solutions and maintained circulating blood volume in spite of increased bleeding. The HA and ISO resuscitations did not exhibit any advantage over LR in resuscitation of solid viscus injury.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 674-680 |
| Number of pages | 7 |
| Journal | Journal of Trauma - Injury, Infection and Critical Care |
| Volume | 39 |
| Issue number | 4 |
| DOIs | |
| State | Published - 1995 |
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ASJC Scopus subject areas
- Surgery
Cite this
Liver injury as a model of uncontrolled hemorrhagic shock : Resuscitation with different hypertonic regimens. / Matsuoka, T.; Hildreth, J.; Wisner, David H.
In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 39, No. 4, 1995, p. 674-680.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Liver injury as a model of uncontrolled hemorrhagic shock
T2 - Resuscitation with different hypertonic regimens
AU - Matsuoka, T.
AU - Hildreth, J.
AU - Wisner, David H
PY - 1995
Y1 - 1995
N2 - Using a standardized liver injury model of uncontrolled hemorrhage, we tested the effect of different hypertonic solutions on mortality, blood pressure, intra-abdominal bleeding, and circulating blood volume. After liver injury, rats were randomized to 4 groups: lactated Ringer's (LR, n = 10), Isosal (ISO, n = 10), hypertonic saline (HS, n = 10), and hypertonic sodium acetate (HA, n = 10). In all resuscitation groups, 4 mL/kg was infused at a rate of 0.4 mL/min. Blood volume was evaluated both directly and by estimation. Mortality was highest after HA resuscitation (40%) and lowest after HS resuscitation (0%), but this difference was not significant. Blood pressure was significantly higher after HS resuscitation, and this difference was sustained for 4 hours. The HA resuscitation did not increase blood pressure compared with LR resuscitation. Intraperitoneal blood volume was significantly higher with HS (25.5 ± 0.7 mL/kg) and HA (26.8 ± 1.2 mL/kg) than with LR (22.5 ± 0.4 mL/kg). The HA resuscitation led to a significantly larger drop from baseline values of estimated terminal circulating blood volume than LR resuscitation. Nonparametric analysis combining survival time and directly measured change in blood volume demonstrated a significant advantage to HS, compared with LR. HA and HS resuscitations increased bleeding from uncontrolled solid viscus injury. The HS resuscitation restored blood pressure better than the other hypertonic solutions and maintained circulating blood volume in spite of increased bleeding. The HA and ISO resuscitations did not exhibit any advantage over LR in resuscitation of solid viscus injury.
AB - Using a standardized liver injury model of uncontrolled hemorrhage, we tested the effect of different hypertonic solutions on mortality, blood pressure, intra-abdominal bleeding, and circulating blood volume. After liver injury, rats were randomized to 4 groups: lactated Ringer's (LR, n = 10), Isosal (ISO, n = 10), hypertonic saline (HS, n = 10), and hypertonic sodium acetate (HA, n = 10). In all resuscitation groups, 4 mL/kg was infused at a rate of 0.4 mL/min. Blood volume was evaluated both directly and by estimation. Mortality was highest after HA resuscitation (40%) and lowest after HS resuscitation (0%), but this difference was not significant. Blood pressure was significantly higher after HS resuscitation, and this difference was sustained for 4 hours. The HA resuscitation did not increase blood pressure compared with LR resuscitation. Intraperitoneal blood volume was significantly higher with HS (25.5 ± 0.7 mL/kg) and HA (26.8 ± 1.2 mL/kg) than with LR (22.5 ± 0.4 mL/kg). The HA resuscitation led to a significantly larger drop from baseline values of estimated terminal circulating blood volume than LR resuscitation. Nonparametric analysis combining survival time and directly measured change in blood volume demonstrated a significant advantage to HS, compared with LR. HA and HS resuscitations increased bleeding from uncontrolled solid viscus injury. The HS resuscitation restored blood pressure better than the other hypertonic solutions and maintained circulating blood volume in spite of increased bleeding. The HA and ISO resuscitations did not exhibit any advantage over LR in resuscitation of solid viscus injury.
UR - http://www.scopus.com/inward/record.url?scp=0028787324&partnerID=8YFLogxK
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U2 - 10.1097/00005373-199510000-00010
DO - 10.1097/00005373-199510000-00010
M3 - Article
C2 - 7473953
AN - SCOPUS:0028787324
VL - 39
SP - 674
EP - 680
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 4
ER -