TY - JOUR
T1 - Uncontrolled Hemorrhage from Parenchymal Injury
T2 - Is Resuscitation Helpful?
AU - Matsuoka, Tetsuya
AU - Hildreth, Jana
AU - Wisner, David H
PY - 1996/6
Y1 - 1996/6
N2 - 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.
AB - 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.
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M3 - Article
C2 - 8656477
AN - SCOPUS:0029888308
VL - 40
SP - 915
EP - 921
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 6
ER -