Effects of hetastarch resuscitation on extravascular lung water and cardiopulmonary parameters in a sheep model of hemorrhagic shock.
Eight sheep, weighing 29-71 kg, were used to evaluate the cardiopulmonary response to Hespan infusion following shock. Before shock was induced, mean arterial pressure (MAP), pulmonary capillary wedge pressure (PCWP), pulmonary artery pressure (PAP), cardiac output (CO), extravascular lung water (EVLW), colloid oncotic pressure (COP), and hemoglobin were measured and shunt, arteriovenous oxygen content difference (C[a - v]O2) and COP-PCWP gradient were calculated. The animals were bled to a MAP of 50 mmHg and that level was maintained for 30 min. At the end of that time, the data were collected again. The animals were resuscitated back to baseline values of PCWP, MAP, and CO with a 6% hydroxyethylstarch solution. With shock, PCWP, MAP, CO, and arterial pH decreased and C(a - v)O2 increased significantly (P less than 0.05). With resuscitation, PAP, PCWP and CO were significantly greater than baseline. Arterial pH was less than the baseline value but was within normal range. MAP did not return to preshock levels. EVLW and venous admixture did not change at any time. C(a - v)O2 returned to baseline with resuscitation. Volume of hetastarch infused was 29.1 +/- 10 cm3/kg. We conclude that hetastarch is an effective resuscitation solution in a model of hemorrhagic shock and appears to have no adverse cardiopulmonary effects.
D000818:Animals; D001834:Body Water / Q000502:physiology; D004195:Disease Models, Animal; D005110:Extracellular Space / Q000187:drug effects*; D006439:Hemodynamics / Q000187:drug effects*; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use*; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D012151:Resuscitation / Q000379:methods*; D012756:Sheep; D012771:Shock, Hemorrhagic / Q000503:physiopathology / Q000628:therapy*; D013213:Starch / Q000031:analogs & derivatives*
D006895:Hydroxyethyl Starch Derivatives; D013213:Starch