Dose response characteristics of hypertonic saline dextran solutions.
In an effort to find the best hypertonic saline-dextran solution (HSD) for prehospital use, 33 chronically catheterized sheep were bled using a fixed pressure shock model (50 mm Hg x 2 hours) and resuscitated with 4 ml/kg of HSD solution (2-minute bolus). In the first set of experiments colloid was varied and sodium chloride was held constant, as 7.5% NaCl was paired with either 0%, 6%, or 12% dextran 70. A dose-response relationship existed, with cardiac output increasing 20% with each sequential dextran 70 concentration. Mean arterial blood pressure was higher in animals that were resuscitated with either the 7.5% NaCl/6% dextran 70 or 7.5% NaCl/12% dextran 70 solution (p less than 0.05). Using the optimal dextran 70 concentration from the first set of experiments (i.e., 12%), solute was varied in a second set of experiments comparing 0.9%, 3.8%, 7.5%, or 10% NaCl/12% dextran 70. Again, dose-response features were demonstrated, as cardiac output increased as a function of NaCl concentration. However, this response plateaued with the 7.5% NaCl concentration and no advantage was obtained by increasing the NaCl concentration to 10%. We conclude that a 4-ml/kg bolus of 7.5% NaCl/12% dextran 70 solution may be a more effective form of therapy than those previously evaluated. This new solution is now being included in our ongoing clinical trials.
Halvorsen
L
L
Department of Surgery, University of California, Davis.
Gunther
R A
RA
Dubick
M A
MA
Holcroft
J W
JW
D000818:Animals; D001794:Blood Pressure; D002302:Cardiac Output; D003911:Dextrans / Q000008:administration & dosage* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D006439:Hemodynamics; D006454:Hemoglobins / Q000032:analysis; D010953:Plasma Volume; D011188:Potassium / Q000097:blood; D012151:Resuscitation; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage* / Q000627:therapeutic use; D012756:Sheep; D012771:Shock, Hemorrhagic / Q000097:blood / Q000503:physiopathology / Q000628:therapy; D012964:Sodium / Q000097:blood
D003911:Dextrans; D006454:Hemoglobins; D012462:Saline Solution, Hypertonic; D012964:Sodium; D011188:Potassium