[Effect of different volumes of fluid resuscitation on hemorrhagic shock with pulmonary edema at high altitude in the unacclimated rat].
OBJECTIVE
To study the effects of different volumes of fluid resuscitation on hemorrhagic shock with pulmonary edema at high altitude in the unacclimated rat.


METHODS
One hundred and twenty-six SD rats transported to Lasa, Tibet, 3 760 meters above the sea level, were anesthetized one week later with sodium pentobarbital (30 mg/kg, intraperitoneal). Hemorrhagic shock with pulmonary edema model was induced by hemorrhage (50 mm Hg for 1 hour, 1 mmHg=0.133 kPa) plus intravenous injection of oleic acid (50 microl/kg). Experiments were then conducted in two parts. Sixty-three rats in part I were equally divided into nine groups (n=7): normal control, hemorrhagic shock control, hemorrhagic shock with pulmonary edema (HSPE) without fluid infusion, HSPE plus infusing lactated Ringer's solution (LR) with 0.5-, 1-, 1.5-, 2- or 3- fold volume shed blood, and 1 volume of LR plus mannitol (10 ml/kg). Hemodynamic parameters including mean arterial blood pressure (MAP), left intraventricular systolic pressure (LVSP) and the maximal change rate of intraventricular pressure rise or decline (+/- dp/dt max) were observed at 15, 30, 60 and 120 minutes after infusion, blood gases were measured at 30 and 120 minutes after infusion and the water content of lung and brain was determined at 120 minutes after infusion. In part II, additional 63 rats were used to observe the effect of different volumes of fluid resuscitation on survival time of HSPE rats.


RESULTS
0.5 volume of LR infusion significantly improved MAP, LVSP and +/- dp/dt max, prolonged the survival time of HSPE animals (all P<0.01), while it did not increase the water content of lung and brain and had no marked influence on blood gases. One volume of LR infusion slightly improved hemodynamic parameters, prolonged the survival time and increased the water content of lung. More than 1 volume of LR infusion including 1.5-, 2- and 3- fold volume LR deteriorated the hemodynamic parameters and decreased the survival time of shocked animal, meanwhile they apparently increased the water content of lung. One volume of LR plus mannitol (10 ml/kg) infusion did not improve the hemodynamic parameters and blood gases; also it did not decrease the water content of lung.


CONCLUSIONS
The tolerance to fluid infusion for the unacclimated animal subjected to hemorrhagic shock with pulmonary edema at high altitude is significantly decreased. 0.5-1 volume of LR infusion appears to be beneficial effect on resuscitation at high altitude, while over 1 volume of LR infusion would aggravate pulmonary edema and exacerbate fluid resuscitation effect.
Liu
Liang-ming
LM
Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, China.
Hu
De-yao
DY
Liu
Jian-cang
JC
Li
Ping
P
Liu
Hou-dong
HD
Xiao
Nan
N
Zhou
Xue-wu
XW
Tian
Kun-lun
KL
Huo
Xiao-ping
XP
Shi
Quan-gui
QG
He
Yan-mei
YM
Yin
Zuo-ming
ZM
D000531:Altitude; D000818:Animals; D005260:Female; D005440:Fluid Therapy; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D011654:Pulmonary Edema / Q000150:complications / Q000628:therapy*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012151:Resuscitation; D000077331:Ringer's Solution; D012771:Shock, Hemorrhagic / Q000150:complications / Q000628:therapy*
D007552:Isotonic Solutions; D000077331:Ringer's Solution