Effects of isotonic saline solution resuscitation on blood coagulation in uncontrolled hemorrhage.
BACKGROUND
It has been suggested that fluid resuscitation before surgical control of hemorrhage may lead to increased bleeding because of the elevated blood pressures and clotting factor dilution. This study was designed to assess the effects of isotonic saline solution resuscitation on blood coagulation during uncontrolled hemorrhage.


METHODS
Twenty-four female Sprague-Dawley rats were randomized into four groups with different resuscitation regimens: group A, no resuscitation; group B, 40 ml/kg in 4 minutes; group C, 80 ml/kg in 4 minutes; and group D, 80 ml/kg in 1 minute. Baseline blood samples were collected just before a sharp resection of 75% of the tail to initiate the hemorrhage; 15 minutes later the resuscitation began. Additional blood samples were obtained at 60 minutes after resection. The blood was analyzed for platelets, fibrinogen, prothrombin time, and activated partial thromboplastin time.


RESULTS
The largest differences between time 0 and 60 minutes were observed in group D with platelets decreasing 43.36% +/- 7.86%, fibrinogen decreasing 57.10% +/- 16.88%, and prothrombin time increasing from an average 16.5 to 19.2 seconds. These differences was statistiacally significant (p <0.05) with the Student's test.


CONCLUSIONS
The results suggested that even though the volume of resuscitation fluid did not appear to affect clotting time when compared with that of nonresuscitated animals, the rate of extremely large volume infusions may play an important role in the cessation of bleeding and consequently in the management of uncontrolled hemorrhagic shock.
Selby
J B
JB
Department of Surgery, Texas Tech University Health Sciences Center, Lubbock 79430, USA.
Mathis
J E
JE
Berry
C F
CF
Hagedorn
F N
FN
Illner
H P
HP
Shires
G T
GT
D000818:Animals; D001777:Blood Coagulation / Q000187:drug effects*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006470:Hemorrhage / Q000097:blood*; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D011517:Prothrombin Time; D051381:Rats; D017207:Rats, Sprague-Dawley; D012151:Resuscitation; D012965:Sodium Chloride / Q000627:therapeutic use*
D012965:Sodium Chloride; D005340:Fibrinogen