Responsiveness to different volume therapies following hemodilution and hemorrhagic shock: a comparative experimental study in rats.

Abstract

UNLABELLED:

Guidelines for volume replacement for acutely hemorrhaged and hemodiluted trauma patients have not been well established.

PURPOSE:

To evaluate the effects of acute hemodilution on mean arterial pressure (MAP), and responsiveness of acutely hemodiluted and subsequently hemorrhaged rats to different volume therapies.

METHODS:

180 rats were hemodiluted to simulate hemorrhaged trauma patients with persistent bleeding after high volume replacement with isotonic solutions. Thirty hemodiluted [Anemia (ANE) group] animals received no further treatment. The remaining 150 animals were subjected to hypovolemic shock and randomized into five groups, according to the treatment option employed: Control (CTL) animals did not receive subsequent treatment after hemorrhagic hypovolemia, SAL4 animals received isotonic saline 4 mL/kg, SAL32 animals received isotonic saline 32 mL/kg, HS animals received hypertonic saline 4 mL/kg and BLD animals received re-infusion of drawn blood.

RESULTS:

Highest mean arterial pressure (MAP) was achieved by BLD, followed by SAL32 and HS. MAP after treatment of BLD, HS, SAL32 and ANE were higher than CTL (p=0.036). At 85 and 95 minutes of experiment, SAL4, SAL32 and HS presented the lowest hematocrit levels (p<0.01). At day 3, ANE, CTL and HS had the highest hematocrit. SAL4 and CTL groups presented the highest mortality rates.

CONCLUSION:

Hypertonic saline is an effective and safe initial therapy for hemodiluted rats undergoing hemorrhagic shock, with an overall outcome comparable to blood replacement or high volume isotonic saline administration.

• Authors: Riad Naim Younes, Fernanda Deutsch, Mario Itinoshe, Belchor Fontes, Renato Poggetti, Dario Birolini
• Journal: Acta cirurgica brasileira (Acta Cir Bras) 2007 Sep-Oct Vol. 22 Issue 5 Pg. 355-60 ISSN: 0102-8650 [Print] Brazil
• PMID: 17923955 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Isotonic Solutions
• Saline Solution, Hypertonic

Topics

• Animals
• Blood Pressure (drug effects, physiology)
• Blood Transfusion
• Blood Volume (physiology)
• Disease Models, Animal
• Hematocrit
• Hemodilution
• Isotonic Solutions (administration & dosage)
• Male
• Rats
• Saline Solution, Hypertonic (administration & dosage)
• Shock, Hemorrhagic (drug therapy, mortality, physiopathology)