title: Hyperpressure intraperitoneal fluid administration for control of bleeding after liver injury.
abstract: BACKGROUND
  Acute hemorrhage is the principal cause of death in trauma patients, with most fatalities occurring during the pre-hospital phase. Recently, intra-abdominal insufflation by carbon dioxide has been shown to drastically reduce bleeding in vascular and splanchnic hemorrhagic animal models simulating the pre-hospital phase. Here, we propose that using dialysate fluid for increasing intra-abdominal pressure is at least as effective as gas with some potential advantages.
  
  
  METHODS
  A novel method of inducing liver trauma was used in 24 White New Zealand rabbits randomized into three groups: intra-abdominal carbon dioxide insufflation (GAS) with 15 cm H(2)O pressure; intra-abdominal infusion of type III dialysate solution (DIAL) with the same pressure; no change in intra-abdominal pressure (CTRL). All groups received intravenous resuscitation when their mean arterial pressure was below 30 mmHg. Physiologic parameters were recorded during 20 min of bleeding.
  
  
  RESULTS
  Red blood cell (RBC) volume loss in the DIAL and GAS was 45% and 48% lower than that in the CTRL, respectively (P < 0.0005). Similar trends were observed for losses in RBC count and hemoglobin (Hb). Final mean arterial pressure, arterial RBC, Hb, and hematocrit were higher in the DIAL and GAS than in the CTRL; glucose concentration in the DIAL group was significantly higher than that in the GAS and CTRL groups. No intravenous fluid therapy was needed in the DIAL group.
  
  
  CONCLUSIONS
  Hyperpressure intraperitoneal dialysate administration successfully reduced bleeding after severe liver injury in rabbits. This method can potentially be used as an adjunct to increase patient survival during pre-hospital cares.
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.
authors.forename: Siavash
authors.initials: S
authors.lastname: Ahmadi-noorbakhsh
authors.forename: Saeed
authors.initials: S
authors.lastname: Azizi
authors.forename: Bahram
authors.initials: B
authors.lastname: Dalir-Naghadeh
authors.forename: Masoud
authors.initials: M
authors.lastname: Maham
mesh_terms: D000208:Acute Disease; D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D015314:Dialysis Solutions / Q000494:pharmacology*; D004195:Disease Models, Animal; D004632:Emergency Medical Services / Q000379:methods; D006470:Hemorrhage / Q000503:physiopathology / Q000628:therapy*; D006863:Hydrogen-Ion Concentration; D006874:Hydrostatic Pressure; D007263:Infusions, Parenteral / Q000379:methods*; D008099:Liver / Q000098:blood supply / Q000293:injuries*; D008102:Liver Circulation / Q000502:physiology; D008297:Male; D008955:Models, Cardiovascular; D011817:Rabbits; D013152:Splanchnic Circulation / Q000502:physiology; D015599:Trauma Severity Indices
chemical_list: D001786:Blood Glucose; D015314:Dialysis Solutions