Hypertonic saline-dextran resuscitation of acute canine bile-induced pancreatitis.
In this study, we examined the effects of hypertonic saline-dextran resuscitation (2,400 mOsm of sodium chloride, 6 percent dextran 70) on cardiopulmonary function and extravascular lung water in acute canine pancreatitis. Acute pancreatitis was induced in 21 dogs by injecting 0.5 ml/kg of autologous bile into the pancreatic duct. In 10 dogs, resuscitation was begun with a 4 ml/kg bolus of hypertonic saline-dextran solution; 11 dogs received no bolus. Lactated Ringer's solution was infused in all dogs to maintain mean arterial pressure and cardiac output at baseline values. Pulmonary hypertension accompanied by a significant increase in pulmonary vascular resistance and a decrease in lung blood flow occurred in those dogs resuscitated with lactated Ringer's solution alone. By contrast, dogs in the hypertonic saline-dextran group maintained pulmonary artery pressure and pulmonary vascular resistance at baseline values while nutritive blood flow to the lung decreased progressively. Our data suggest that hypertonic saline-dextran resuscitation effectively restores cardiac function while it significantly reduces fluid requirements, as well as the pulmonary hypertension and pulmonary edema that frequently accompany lactated Ringer's resuscitation of acute pancreatitis.
Horton
J W
JW
Department of Surgery, University of Texas Southwestern Medical Center, Dallas 75235-9031.
Dunn
C W
CW
Burnweit
C A
CA
Walker
P B
PB
D000136:Acid-Base Equilibrium; D000208:Acute Disease; D000818:Animals; D001646:Bile; D003911:Dextrans / Q000008:administration & dosage*; D004285:Dogs; D005110:Extracellular Space / Q000378:metabolism; D005440:Fluid Therapy / Q000379:methods; D006439:Hemodynamics; D007552:Isotonic Solutions / Q000008:administration & dosage; D008168:Lung; D008297:Male; D010101:Oxygen Consumption; D010195:Pancreatitis / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy; D011652:Pulmonary Circulation; D012151:Resuscitation / Q000379:methods; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage*; D012965:Sodium Chloride / Q000008:administration & dosage*
D003911:Dextrans; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic; D012965:Sodium Chloride