title: Improved survival after resuscitation with norepinephrine in a murine model of uncontrolled hemorrhagic shock.
abstract: BACKGROUND
  Recent studies have challenged current guidelines on fluid resuscitation. However, studies on resuscitation using norepinephrine in uncontrolled hemorrhagic shock are lacking. The authors examined the effects of norepinephrine in combination with saline infusion in uncontrolled hemorrhage in rats.
  
  
  METHODS
  Rats subjected to a 15-min controlled hemorrhage (withdrawal of 3 ml blood/100 g body mass) followed by a 60-min uncontrolled hemorrhage (75% tail amputation) were randomly assigned to one of several treatment groups (10 rats/group) receiving different doses of norepinephrine (0 [NE0], 5 [NE5], 50 [NE50], or 500 [NE500] microg.100 g(-1).h(-1)). In the four hypotensive resuscitation groups (n = 40), mean arterial pressure was not allowed to fall below 40 mmHg by titrated infusion of normal saline. In the four normotensive resuscitation groups (n = 40), it was not allowed to fall below 80 mmHg. The endpoint was survival at 210 min.
  
  
  RESULTS
  There was a significant difference (P < 0.05) in survival rate among groups. Among the hypotensive rats, 6 (60%) survived in the NE0 and NE5 dose groups, 9 (90%) survived in the NE50 dose group, and none survived in the NE500 dose group. Among the normotensive rats, none survived in the NE0 group, 4 (40%) survived in the NE5 dose group, all 10 (100%) survived in the NE50 group, and none survived in the NE500 group.
  
  
  CONCLUSIONS
  The early use of norepinephrine in uncontrolled hemorrhagic shock in rats significantly improved survival when infused at a rate of 50 microg.100 g(-1).h(-1) in normotensive and hypotensive resuscitation strategies.
authors: Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Université Paris 13, France.
authors: Marie-Pierre
authors: MP
authors: Poloujadoff
authors: Stephen W
authors: SW
authors: Borron
authors: Roland
authors: R
authors: Amathieu
authors: Fabrice
authors: F
authors: Favret
authors: Mamadou S
authors: MS
authors: Camara
authors: Frédéric
authors: F
authors: Lapostolle
authors: Eric
authors: E
authors: Vicaut
authors: Frédéric
authors: F
authors: Adnet
mesh_terms: D000818:Animals; D001784:Blood Gas Analysis; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D001810:Blood Volume / Q000502:physiology; D016887:Cardiopulmonary Resuscitation; D003627:Data Interpretation, Statistical; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D009638:Norepinephrine / Q000627:therapeutic use*; D051381:Rats; D012771:Shock, Hemorrhagic / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D013534:Survival; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
chemical_list: D014662:Vasoconstrictor Agents; D009638:Norepinephrine