Hypertonic saline resuscitation: saturated salt-dextran solutions are equally effective, but induce hemolysis in dogs.
Hypertonic saline, or saline-dextran resuscitation is normally achieved with an Na+ load of 4.8 to 7.2 mEq/kg given in a small volume (typically 4 to 6 ml/kg NaCl 7.5%). Na+ can also be administered saturated in a smaller volume, e.g., 1 to 1.5 ml/kg NaCl 25%, with similar results. Such reduction in administered volume would be an asset in prehospital trauma management. In the present experiments, severely bled (45 ml/kg) dogs were treated with one of three NaCl/dextran-70 solutions: S1, 25% NaCl + 24% dextran (1.5 ml/kg); S2, 15% NaCl + 14.4% dextran (2.5 ml/kg); S3, 7.5% NaCl + 6% dextran (5 ml/kg). S1, S2, and S3 were pump-infused in 10 min into a peripheral vein; S1 and S2 were also given into the right atrium. S1, S2, or S3 produced a number of similar responses irrespective of the route of administration; arterial pressure, cardiac index, and base excess reverted to near control levels, plasma Na+ was raised to 155-158 mEq/L, and 5-day survival was high and comparable. Plasma volume, and total and mean red cell volumes were similarly affected in all groups; however, peripheral injections of S1 and S2 induced severe hemolysis (plasma Hgb: 53 +/- 6 and 34 +/- 4 mg/dl, respectively), while right atrial S1 and S2 caused mild hemolysis (22 +/- 3 and 14 +/- 3 mg/dl, respectively). In contrast, S3 never induced hemolysis.(ABSTRACT TRUNCATED AT 250 WORDS)
Rocha e Silva
M
M
Research Division, Faculdade de Medicina, Universidade de São Paulo, Brasil.
Velasco
I T
IT
Porfirio
M F
MF
D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D003911:Dextrans / Q000008:administration & dosage / Q000627:therapeutic use*; D004285:Dogs; D004305:Dose-Response Relationship, Drug; D006461:Hemolysis / Q000187:drug effects*; D008297:Male; D009994:Osmolar Concentration; D010953:Plasma Volume; D012151:Resuscitation; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D012769:Shock / Q000188:drug therapy*; D012965:Sodium Chloride / Q000008:administration & dosage / Q000009:adverse effects*
D003911:Dextrans; D012462:Saline Solution, Hypertonic; D012965:Sodium Chloride