Uncontrolled Hemorrhage from Parenchymal Injury: Is Resuscitation Helpful?

Tetsuya Matsuoka, Jana Hildreth, David H Wisner

Research output: Contribution to journalArticlepeer-review

47 Scopus citations

Abstract

Fluid resuscitation increases blood pressure and may increase hemorrhage. We tested this hypothesis in a model of liver injury. After standardized injury, rats were randomized into four groups: no resuscitation (NR, n = 30), small volume lactated Ringer's solution (SVLR, 4 mL/kg, n = 30), large volume lactated Ringer's solution (LVLR, 24 mL/kg, n = 30), and hypertonic saline (HS, 4 mL/kg, n = 30). Terminal circulating volume was estimated using controlled hemorrhage experiments. Survival times and mortality rates were significantly lower in HS animals (10%) than in NR (50%) or SVLR (47%) animals. Blood pressure was significantly higher after HS, and this difference was sustained. Intraperitoneal blood volume was significantly higher with HS (26.0 ± 0.7 mL/kg) and LVLR (26.9 ± 0.6 mL/kg) compared with NR (21.5 ± 0.7 mL/kg) and SVLR (22.5 ± 0.7 mL/kg). Estimated terminal blood volume was significantly decreased in LVLR (29.3 ± 0.6 mL/kg) compared with NR (33.3 ± 0.7 mL/kg), SVLR (33.7 ± 0.8 mL/kg), and HS (31.7 ± 0.7 mL/kg). Conclusion: Vigorous resuscitation increases bleeding from solid viscus injury. Small volume HS improves blood pressure and survival compared with no resuscitation. Results of large vessel hemorrhage models may not apply to parenchymal viscus injury.

Original languageEnglish (US)
Pages (from-to)915-921
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume40
Issue number6
StatePublished - Jun 1996

ASJC Scopus subject areas

  • Surgery

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