Effect of dehydration on cardiovascular responses and electrolytes after hypertonic saline/dextran treatment for moderate hemorrhage.
OBJECTIVE
To determine if hypertonic saline/dextran (HSD) is effective in treating hemorrhage in the presence of dehydration.


METHODS
After surgical preparation, swine were euhydrated or dehydrated for 24 or 48 hours. Animals were bled 25 mL/kg over 60 minutes and treated with HSD.


METHODS
Laboratory.


METHODS
Seventeen immature Yorkshire pigs.


METHODS
4 mL/kg HSD (7.5% NaCl in 6% dextran-70) administered over one minute.


RESULTS
All euhydrated animals survived; 100% of the pigs survived 180 minutes after treatment. Two animals dehydrated for 24 hours and three animals dehydrated for 48 hours died within three hours of HSD treatment. In all groups, plasma potassium was reduced significantly and equally; cardiac output was increased; mean arterial pressure rose rapidly within first five minutes, but was sustained only in euhydrated animals; hematocrit, hemoglobin, and plasma total protein levels were reduced; and plasma glucose increased with persistent between-group differences.


RESULTS
HSD immediately rectified the decreases in mean arterial pressure and cardiac output incurred during hemorrhage; over time, however, the improvement in pressure was not sustained in dehydrated pigs. Parallel increases in plasma osmolality and sodium concentrations were offset by the initial group differences resulting from dehydration.


CONCLUSIONS
Dehydration does not compromise the efficacy of HSD as a resuscitation treatment for hemorrhagic shock.
Wade
C E
CE
Division of Military Trauma Research, Letterman Army Institute of Research, Presidio of San Francisco, California.
Tillman
F J
FJ
Loveday
J A
JA
Blackmon
A
A
Potanko
E
E
Hunt
M M
MM
Hannon
J P
JP
D000818:Animals; D001835:Body Weight; D003681:Dehydration / Q000150:complications*; D003911:Dextrans / Q000627:therapeutic use*; D004573:Electrolytes / Q000097:blood*; D006439:Hemodynamics / Q000502:physiology*; D009994:Osmolar Concentration; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D012771:Shock, Hemorrhagic / Q000097:blood / Q000150:complications / Q000628:therapy*; D013552:Swine
D003911:Dextrans; D004573:Electrolytes; D012462:Saline Solution, Hypertonic