title: [Effect of different volumes of fluid resuscitation on hemorrhagic shock with pulmonary edema at high altitude in the unacclimated rat].
abstract: 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.
authors.affiliation: Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, China.
authors.forename: Liang-ming
authors.initials: LM
authors.lastname: Liu
authors.forename: De-yao
authors.initials: DY
authors.lastname: Hu
authors.forename: Jian-cang
authors.initials: JC
authors.lastname: Liu
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.forename: Hou-dong
authors.initials: HD
authors.lastname: Liu
authors.forename: Nan
authors.initials: N
authors.lastname: Xiao
authors.forename: Xue-wu
authors.initials: XW
authors.lastname: Zhou
authors.forename: Kun-lun
authors.initials: KL
authors.lastname: Tian
authors.forename: Xiao-ping
authors.initials: XP
authors.lastname: Huo
authors.forename: Quan-gui
authors.initials: QG
authors.lastname: Shi
authors.forename: Yan-mei
authors.initials: YM
authors.lastname: He
authors.forename: Zuo-ming
authors.initials: ZM
authors.lastname: Yin
mesh_terms: 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*
chemical_list: D007552:Isotonic Solutions; D000077331:Ringer's Solution