Efficacy of osmolality and ionic composition of resuscitation fluids for treatment of acute blood loss in the spontaneously hypertensive rat (SHR).
The spontaneously hypertensive rat (SHR) has a deficient glucose mobilization in response to blood loss. Treatment of blood loss with hypertonic glucose might consequently be advantageous in SHR, but the importance of osmolality as compared to ionic composition of resuscitation fluids is still not fully elucidated. Therefore, SHR (n = 32) were subjected to hemorrhage (30% of calculated blood volume) followed by treatment with (1) hypertonic saline (HS; 4.5 ml/kg of 7.5% NaCl, 2,400 mOsm/L), (2) hypertonic glucose (HG; 4.5 ml/kg of 42.3% solution, 2,400 mOsm/L), and (3) normal saline (NS; 37.5 ml/kg of 0.9% NaCl) to provide an equal sodium load as with HS. All fluid regimens increased (P < 0.001 vs. control) mean arterial pressure (MAP). Hemodilution was more pronounced after HS and NS than after HG. Hypernatremia was evoked by HS. The hyperglycemic response to hemorrhage was intensified by HG, but it was accompanied by increased blood lactate levels. All three treatment regimens prolonged posthemorrhagic times until death (P < 0.01-0.05) (mean values: NS 363 min; HS 170 min; HG 146 min; nontreated controls 60 min). It is concluded, on the basis of hemodynamic, metabolic, and times-until-death data, that although treatment with small-volume HS seems superior to small-volume HG, an equal load of sodium given as NS is more effective for resuscitation after blood loss than HS in SHR.
Waagstein
L M
LM
Department of Anesthesiology, University of Göteborg, Sahlgren's Hospital, Sweden.
Wennberg
E
E
Haljamäe
H
H
D000208:Acute Disease; D000818:Animals; D001774:Blood Chemical Analysis; D005950:Glucose Solution, Hypertonic / Q000627:therapeutic use; D006439:Hemodynamics; D006470:Hemorrhage / Q000628:therapy*; D008297:Male; D009994:Osmolar Concentration; D051381:Rats; D011918:Rats, Inbred SHR; D012151:Resuscitation / Q000379:methods*; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use
D005950:Glucose Solution, Hypertonic; D012462:Saline Solution, Hypertonic