Hypertonic and hyperoncotic resuscitation from severe hemorrhagic shock in dogs: a comparative study.
Single bolus injections of hypertonic (7.5%) NaCl (H), hyperoncotic (6%) dextran-70 (D), or of their combination (HD) were given to severely bled (54.2 +/- 1.3 ml/kg) anesthetized dogs. Two shock procedures (30 or 60 min at 35 mm Hg) were tested. Survival was highest (11/12) after HD, lower (9/12) after H, and lowest (7/12) after D; it was higher (15/18 vs. 12/18) after the shorter vs. longer shock procedure. Cardiac index (CI) was restored to 83%-104% of prehemorrhage levels immediately after HD or H; 3 h later it was down to 67%-71% of control; after D, CI was stable at 41% to 50% of control; no differences in the relative performances of the agents tested in the 30 or 60-min shock durations. Arterial pressure recovered to near control levels in all groups; consequently, systemic vascular resistance was reduced after H and HD, but increased after D. Plasma volume recovered to 95% of control after H, 105% of control after HD, but only to 80% after D; however, the response to H was transient. Metabolic acidosis was partially reverted by all solutions. Plasma Na+ was transiently raised by H and HD. Overall differences detected between H vs. HD tend to favor HD as a resuscitative solution.
Velasco
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IT
Research Division, Faculdade de Medicina, Universidade de São Paulo, Brazil.
Rocha e Silva
M
M
Oliveira
M A
MA
Oliveira
M A
MA
Silva
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RI
D000818:Animals; D001784:Blood Gas Analysis; D001794:Blood Pressure / Q000187:drug effects; D001804:Blood Transfusion, Autologous; D001810:Blood Volume; D002302:Cardiac Output / Q000187:drug effects; D003911:Dextrans / Q000008:administration & dosage / Q000627:therapeutic use*; D004285:Dogs; D004338:Drug Combinations; D008297:Male; D011379:Prognosis; D012151:Resuscitation; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000627:therapeutic use*; D012771:Shock, Hemorrhagic / Q000188:drug therapy*; D012965:Sodium Chloride / Q000627:therapeutic use*
D003911:Dextrans; D004338:Drug Combinations; D012462:Saline Solution, Hypertonic; D012965:Sodium Chloride