title: Early fluid resuscitation with hypertonic solution in a rat crush injury model.
abstract: OBJECTIVE
  The aim of the study was to evaluate the effects of bolus infusion of hypertonic hydroxyethyl starches (HHESs) and continuous infusion of hypertonic saline (HTS) in the early resuscitation in crush syndrome.
  
  
  METHODS
  A rat model of crush injury was established. Rats were randomly divided into five groups: (1) HHES group, (2) HTS group, (3) volume resuscitation group, (4) normal resuscitation (NR) group, and (5) sham group. Blood samples were collected 6 h after the crush period for biochemical evaluation. Blood pressure was monitored throughout this experiment. Muscles and kidneys were evaluated morphologically 24 h after reperfusion. Twenty rats in each group were taken for survival observation for 72 h.
  
  
  RESULTS
  Compared with the NR and HTS groups, the HHES group had significantly increased the survival rate 72 h after release (P < 0.05). In the first 2 h after release, mean arterial blood pressure in the HHES group was significantly higher than in HTS, volume resuscitation, and NR groups (respectively, P < 0.05). Animals that received HHES infusion showed a better acid-base balance and renal function. However, there was no significant difference in survival rate between the HTS and NR groups. Furthermore, animals in the HTS group showed a bad acid-base balance and a higher serum sodium level.
  
  
  CONCLUSIONS
  Bolus infusion of HHES combined with normal saline could be an effective therapy for crush syndrome in the early resuscitation period. However, continuous HTS injection was not seemed to be a suitable choice particularly in the absence of monitoring equipment for serum irons or blood gases (institutional protocol no. ZN5R20110016).
authors.affiliation: Emergency Department, Zhongnan Hospital, Wuhan University, Hubei, China.
authors.forename: Xiao-Bing
authors.initials: XB
authors.lastname: Song
authors.forename: Xian-Long
authors.initials: XL
authors.lastname: Zhou
authors.forename: Shao-Zhou
authors.initials: SZ
authors.lastname: Ni
authors.forename: Gui-Fang
authors.initials: GF
authors.lastname: Yang
authors.forename: Su-Fang
authors.initials: SF
authors.lastname: Tian
authors.forename: Jiang
authors.initials: J
authors.lastname: Shan
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhao
authors.forename: Jun
authors.initials: J
authors.lastname: Shen
authors.forename: Xiang
authors.initials: X
authors.lastname: Wang
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D051381:Rats; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D014947:Wounds and Injuries / Q000628:therapy*
chemical_list: D012462:Saline Solution, Hypertonic