title: The detrimental effects of intravenous crystalloid after aortotomy in swine.
abstract: We tested the hypothesis that, after aortotomy, rapidly replacing three times the blood volume deficit with intravenous crystalloid will increase hemorrhage and decrease survival. Sixteen anesthetized Yorkshire swine underwent splenectomy and stainless steel wire placement in the infrarenal aorta and were instrumented with pulmonary artery and carotid artery catheters. The wire was pulled, producing a 5 mm aortotomy and spontaneous intraperitoneal hemorrhage. The animals had been alternately assigned to either an untreated control group (n = 8) or a treatment group (n = 8), which received 80 ml/kg lactated Ringer's solution intravenously. The volume of hemorrhage and the mortality rate were significantly increased (p less than 0.05) in the treatment group receiving lactated Ringer's solution relative to the control animals (2142 +/- 178 ml versus 783 +/- 85 ml, and eight of eight animals versus zero of eight animals, respectively). From these data we conclude that, in this model of uncontrolled arterial hemorrhage resulting from abdominal aortotomy, rapidly administering lactated Ringer's solution intravenously significantly increases hemorrhage and death.
authors.affiliation: Division of Military Trauma Research, Letterman Army Institute of Research, Presidio of San Francisco, CA 94129-6800.
authors.forename: W H
authors.initials: WH
authors.lastname: Bickell
authors.forename: S P
authors.initials: SP
authors.lastname: Bruttig
authors.forename: G A
authors.initials: GA
authors.lastname: Millnamow
authors.forename: J
authors.initials: J
authors.lastname: O'Benar
authors.forename: C E
authors.initials: CE
authors.lastname: Wade
mesh_terms: D000136:Acid-Base Equilibrium; D000818:Animals; D001012:Aorta, Abdominal / Q000601:surgery*; D000077324:Crystalloid Solutions; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006470:Hemorrhage / Q000503:physiopathology / Q000628:therapy*; D007262:Infusions, Intravenous; D007552:Isotonic Solutions; D007773:Lactates / Q000008:administration & dosage; D019344:Lactic Acid; D010100:Oxygen / Q000097:blood; D010952:Plasma Substitutes / Q000008:administration & dosage / Q000009:adverse effects*; D013552:Swine
chemical_list: D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D007773:Lactates; D010952:Plasma Substitutes; D019344:Lactic Acid; D010100:Oxygen