Pentafraction-Du Pont versus albumin for resuscitation of a lethal intestinal ischemic shock in rats.
This study compares the effect of pentafraction-Du Pont 6% (PF), albumin 5% (ALB), and Ringer's lactate (RL) on plasma volume (PV) expansion and survival in a lethal intestinal ischemic shock model. Shock was induced by exteriorizing the small intestines and occluding the mesenteric vessels for 75 min. Changes in PV were estimated using hematocrit (Hct). The solutions were administered continuously for 6 hr in volumes to maintain a stable Hct, or 15 ml/100 g body weight (bwt) for PF and ALB and 44 ml/100 g bwt for RL. Hct and bwt were measured hourly during the infusion and at 24 h. Untreated animals in shock developed hemoconcentration (Hct 62%) corresponding to a PV of 41% of baseline preshock level, with 9% (3/35) of the animals surviving 72 hr. RL expanded PV to 87% of preshock level, with a 57% (20/35) 72 hr survival rate and 46% (16/35) surviving greater than 7 days. Only 34% as much ALB was needed to induce a greater PV expansion of 101% with a 72 hr survival rate of 51% (18/35) and 46% (16/35) surviving greater than 7 days. When PF was used, PV expanded to 109% of preshock level with survival rates improving to 80% (28/35) at 72 hr and 71% (25/35) greater than 7 days compared to RL and ALB (P less than 0.05). There were no significant differences in survival rates between RL and ALB treated animals. We conclude that PF improves survival following intestinal ischemic shock compared to ALB and RL. PF is a safe and effective alternative to albumin for resuscitation in this shock model.
Willms
C D
CD
Department of Surgery, University of Texas Southwestern Medical Center, Dallas 75235.
Dawidson
I J
IJ
Armstrong
J M
JM
Kwon
M
M
Risser
R
R
Sandor
Z F
ZF
Sentementes
J T
JT
D000418:Albumins / Q000627:therapeutic use*; D000818:Animals; D005440:Fluid Therapy; D006400:Hematocrit; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use*; D007422:Intestines / Q000098:blood supply; D007511:Ischemia; D007552:Isotonic Solutions / Q000627:therapeutic use; D008297:Male; D010952:Plasma Substitutes / Q000627:therapeutic use*; D010953:Plasma Volume; D051381:Rats; D011919:Rats, Inbred Strains; D000077325:Ringer's Lactate; D012769:Shock / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*
D000418:Albumins; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D000077325:Ringer's Lactate