The renal effects of 7.5% NaCl-6% dextran-70 versus lactated Ringer's resuscitation of hemorrhage in dehydrated sheep.
A small volume of 7.5% NaCl/6% Dextran-70 (HSD) can rapidly expand the plasma volume, but concerns exist regarding its adverse effects on renal function in the dehydrated state. Sheep were thirsted for 4 days (13% plasma volume contraction), and subjected to a fixed-pressure shock model (mean arterial pressure of 50 mmHg for 2 h), followed by resuscitation with either HSD (4 mL/kg) or lactated Ringer's solution (LR; 37 mL/kg). Mean arterial pressure was restored to 90%, cardiac output to 125% and 120%, and plasma volume to 78% and 72% of baseline in LR and HSD groups, respectively. Glomerular filtration rate improved to 100% of baseline following HSD compared with 82% following LR. No significant urinary 70,000 molecular weight dextran was observed, suggesting an intact renal glomerular membrane. These data suggest that small volume HSD resuscitation is effective, even with pre-existing dehydration. In addition, renal function is not compromised by HSD resuscitation of hemorrhaged, dehydrated animals.
Ho
H S
HS
Department of Surgery, University of California at Davis, School of Medicine 95616, USA.
Sondeen
J L
JL
Dubick
M A
MA
Wade
C E
CE
Gunther
R A
RA
D000818:Animals; D003681:Dehydration / Q000150:complications / Q000188:drug therapy*; D003911:Dextrans / Q000494:pharmacology*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006470:Hemorrhage / Q000150:complications / Q000188:drug therapy*; D007552:Isotonic Solutions / Q000494:pharmacology*; D007668:Kidney / Q000033:anatomy & histology / Q000187:drug effects / Q000502:physiology; D051437:Renal Insufficiency / Q000188:drug therapy; D012151:Resuscitation; D000077325:Ringer's Lactate; D012756:Sheep; D012965:Sodium Chloride / Q000494:pharmacology
D003911:Dextrans; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D012965:Sodium Chloride