Treatment of hemorrhagic shock with intraosseous or intravenous infusion of hypertonic saline dextran solution.

Abstract

The efficacy of intravenous or intraosseous infusion of 250 ml of 7.5% NaCl and 6% dextran 60 (H/H) was compared with intravenous Ringer's lactate (RL) for the initial treatment of patients with hemorrhagic shock due to upper gastrointestinal bleeding. 49 patients were randomly assigned to receive either H/H (n = 26) or RL (n = 23). In the first 16 patients with H/H and in all RL patients, solutions were infused by the intravenous route, while the intraosseous route through sternal puncture was chosen for the last 10 H/H subjects. H/H patients were analyzed together since no differences were noticed between the routes of infusion. The H/H group also received 2.3 +/- 0.7 liters of intravenous crystalloid solutions in the first hour and 4.4 +/- 0.1 liters in the 24-hour period, while RL received 3.3 +/- 0.7 and 7.3 +/- 2.4 liters, respectively. Blood pressure (BP) increased during the first 15 min in the H/H group (from 61 +/- 17/30 +/- 12 to 85 +/- 30/48 +/- 14 mm Hg) and thereafter, while remaining unchanged in the RL group (from 75 +/- 18/40 +/- 12 to 75 +/- 17/40 +/- 14 mm Hg; p less than 0.05). The differences between groups were significant throughout 24 h. Urine output and improvement of the Glasgow Coma Score were also higher in H/H patients than in the control group (p less than 0.05). There were 5 deaths in RL group and 1 in the H/H group. Sternal of peripheral vein infusion of 250 ml of 7.5% NaCl/6% dextran 60 is an effective initial treatment of hemorrhagic shock.

• Authors: A Chávez-Negrete, S Majluf Cruz, A Frati Munari, A Perches, R Argüero
• Journal: European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes (Eur Surg Res) Vol. 23 Issue 2 Pg. 123-9 ( 1991) ISSN: 0014-312X [Print] Switzerland
• PMID: 1718756 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Dextrans
• Saline Solution, Hypertonic

Topics

• Blood Pressure
• Dextrans (administration & dosage, therapeutic use)
• Humans
• Infusions, Intravenous
• Injections
• Saline Solution, Hypertonic (administration & dosage, therapeutic use)
• Shock, Hemorrhagic (blood, physiopathology, therapy)
• Sternum
• Time Factors