title: Large volume crystalloid resuscitation does not increase extravascular lung water.
abstract: The purpose of this study was to determine whether Ringer's lactate solution increases extravascular lung water (EVLW) during resuscitation after hemorrhagic shock. Ten sheep anesthetized with thiamylal were bled to a mean arterial pressure (MAP) of 50 mm Hg; further bleeding maintained that pressure for 30 min. Resuscitation fluid consisted of Ringer's lactate solution in volumes necessary to restore and maintain for 1 hr MAP, pulmonary capillary wedge pressure (PCWP), and cardiac index at levels equal to those measured before bleeding. After volume replacement, the colloid oncotic pressure (COP) - PCWP gradient (COP - PCWP) decreased from 12 +/- 3 to 2 +/- 5 mm Hg (P less than 0.001). After volume restoration, COP decreased from 19 +/- 8 mm Hg to 12 +/- 2 mm Hg (P less than 0.001). Despite the large volume of fluid administered, EVLW did not increase. Crystalloid resuscitation does not necessarily increase EVLW despite significant decreases in COP and COP - PCWP gradient.
mesh_terms: D000818:Animals; D001834:Body Water / Q000378:metabolism*; D000077324:Crystalloid Solutions; D005110:Extracellular Space / Q000378:metabolism*; D005440:Fluid Therapy / Q000379:methods*; D007552:Isotonic Solutions / Q000627:therapeutic use; D008168:Lung / Q000378:metabolism*; D010952:Plasma Substitutes / Q000627:therapeutic use*; D011669:Pulmonary Wedge Pressure; D012151:Resuscitation; D000077325:Ringer's Lactate; D012756:Sheep; D012771:Shock, Hemorrhagic / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy
chemical_list: D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D000077325:Ringer's Lactate