Abstract |
Thoracoabdominal aortic surgery with aortic clamping is normally associated with major volemic shifts when the clamp is removed. This study compares the hemodynamic effects of hypertonic (HS) and isotonic (IS) solutions of sodium chloride (NaCl) infusions on the severe hypotension which follows aortic unclamping. Five consecutive patients received HS, and five received IS immediately after aortic unclamping. Blood loss, diuresis, and blood and crystalloid infusions were monitored throughout the operation. Blood gases, and pH, and hematocrit, hemoglobin, and plasma electrolyte levels were controlled during and 24 hours after surgery. Systemic arterial pressure, pulmonary arterial and wedge pressures, cardiac output, and systemic and pulmonary vascular resistance were monitored at the start of the operation, during aortic clamping, immediately after unclamping, immediately after HS or IS NaCl infusion and at the end of the operation. Patients who received HS NaCl exhibited higher pulmonary arterial and wedge pressures, higher cardiac index, and lower systemic and pulmonary vascular resistances immediately after the infusion. These patients required less volume transfusion than patients who received IS NaCl, despite slightly higher blood losses. It is concluded that HS NaCl is useful for the treatment of human hemorrhagic shock.
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Authors | J O Auler Jr, M H Pereira, R V Gomide-Amaral, N G Stolf, A D Jatene, M Rocha e Silva |
Journal | Surgery
(Surgery)
Vol. 101
Issue 5
Pg. 594-601
(May 1987)
ISSN: 0039-6060 [Print] United States |
PMID | 3576451
(Publication Type: Journal Article)
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Chemical References |
- Isotonic Solutions
- Saline Solution, Hypertonic
- Sodium Chloride
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Topics |
- Adult
- Aged
- Aortic Dissection
(surgery)
- Aorta, Abdominal
(surgery)
- Aorta, Thoracic
(surgery)
- Aortic Aneurysm
(surgery)
- Constriction
- Drug Evaluation
- Female
- Hemodynamics
(drug effects)
- Humans
- Intraoperative Period
- Isotonic Solutions
- Male
- Middle Aged
- Saline Solution, Hypertonic
(pharmacology)
- Shock, Hemorrhagic
(drug therapy)
- Sodium Chloride
(pharmacology)
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