title: Resuscitation of canine hemorrhagic hypotension with large-volume isotonic crystalloid: impact on lung water, venous admixture, and systemic arterial oxygen saturation.
abstract: The objective of this study was to test the hypothesis that after hemorrhagic hypotension, reinfusion of the shed blood with threefold that volume of lactated Ringer's (LR) solution will significantly increase lung water and venous admixture and hence decrease systemic arterial oxygen saturation. A prospective, randomized, fixed-volume hemorrhage laboratory study was performed at the Oklahoma University Health Sciences Center on 18 anesthetized mongrel dogs. After 40 mL/kg of blood were withdrawn through a femoral artery catheter, the dogs were randomized either to the control group (n = 9) that received a reinfusion of the shed blood, or to the LR treatment group (n = 9) that received an intravenous mixture of the shed blood with 120 mL/kg of LR. After fluid resuscitation, pulmonary artery occlusion pressure (PAOP) and cardiac output (CO) were significantly increased in the LR group compared with control animals (PAOP, 18.7 +/- 1.1 vs 13.4 +/- 2.9 mm Hg; CO, 8.14 +/- 1.08 vs 4.59 +/- 0.47 L/min; P < .05 each). However, lung water, venous admixture, and systemic arterial PO2 were similar between groups. In this fixed-volume hemorrhage model, hemodiluting the reinfused shed blood with threefold the volume of LR did not significantly influence lung water, venous admixture, or systemic arterial oxygen saturation.
authors.affiliation: Department of Emergency Services, Saint Francis Hospital, Tulsa, OK.
authors.forename: W H
authors.initials: WH
authors.lastname: Bickell
authors.forename: S M
authors.initials: SM
authors.lastname: Barrett
authors.forename: M
authors.initials: M
authors.lastname: Romine-Jenkins
authors.forename: S S
authors.initials: SS
authors.lastname: Hull
authors.forename: G T
authors.initials: GT
authors.lastname: Kinasewitz
mesh_terms: D000818:Animals; D004285:Dogs; D015633:Extravascular Lung Water / Q000187:drug effects*; D005440:Fluid Therapy; D006439:Hemodynamics; D006470:Hemorrhage / Q000097:blood / Q000503:physiopathology; D007022:Hypotension / Q000097:blood / Q000503:physiopathology; D007552:Isotonic Solutions / Q000494:pharmacology / Q000627:therapeutic use*; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange; D011897:Random Allocation; D012771:Shock, Hemorrhagic / Q000097:blood / Q000503:physiopathology / Q000628:therapy*
chemical_list: D007552:Isotonic Solutions; D010100:Oxygen