Using a standardized liver injury model of uncontrolled
hemorrhage, we tested the effect of different
hypertonic solutions on mortality, blood pressure, intra-abdominal
bleeding, and circulating blood volume. After liver injury, rats were randomized to 4 groups:
lactated Ringer's (LR, n = 10),
Isosal (ISO, n = 10), hypertonic saline (HS, n = 10), and hypertonic
sodium acetate (HA, n = 10). In all
resuscitation groups, 4 mL/kg was infused at a rate of 0.4 mL/min. Blood volume was evaluated both directly and by estimation. Mortality was highest after HA
resuscitation (40%) and lowest after HS
resuscitation (0%), but this difference was not significant. Blood pressure was significantly higher after HS
resuscitation, and this difference was sustained for 4 hours. The HA
resuscitation did not increase blood pressure compared with LR
resuscitation. Intraperitoneal blood volume was significantly higher with HS (25.5 +/- 0.7 mL/kg) and HA (26.8 +/- 1.2 mL/kg) than with LR (22.5 +/- 0.4 mL/kg). The HA
resuscitation led to a significantly larger drop from baseline values of estimated terminal circulating blood volume than LR
resuscitation. Nonparametric analysis combining survival time and directly measured change in blood volume demonstrated a significant advantage to HS, compared with LR. HA and HS
resuscitations increased
bleeding from uncontrolled solid viscus injury. The HS
resuscitation restored blood pressure better than the other
hypertonic solutions and maintained circulating blood volume in spite of increased
bleeding. The HA and ISO
resuscitations did not exhibit any advantage over LR in
resuscitation of solid viscus injury.