title: Hypertonic saline, normal saline or neither: which is best for uncontrolled hemorrhagic shock? An experimental study in goats.
abstract: BACKGROUND
  To evaluate the effects of various fluids on uncontrolled hemorrhagic shock (UHS). Controversy exists over the appropriate doses and types of fluids for best treating UHS. This study evaluated the effects of hypertonic saline (HTS), normal saline (NS), and no fluid resuscitation (NFR) on UHS.
  
  
  METHODS
  Thirty goats were anesthetized and underwent right leg ablation. The animals were randomly assigned to equal NFR, HTS, and NS groups. The following features of UHS were analyzed: hemoglobin, heart rate, blood loss, mean arterial pressure, bleeding time, and pH. Animals were sacrificed two hours after ablation.
  
  
  RESULTS
  All of the goats who received HTS died within 60 minutes. Four goats in the NS group and one goat in the NFR group died within 120 minutes. The NFR group had significantly higher hemoglobin values than the NS and HTS groups at the end of the trial. Blood loss in the HTS group was greater than in the other two groups (p<0.05). The NS group had higher blood loss than the NFR group (p<0.05). Mean arterial pressure in the HTS group decreased sharply toward zero within the first 60 minutes. In the NFR and NS groups, mean arterial pressure was higher than in the HTS group (p<0.05), and remained constant at 60mmHg after 35 minutes. The NFR group had higher pH values compared to the other two groups (p<0.05).
  
  
  CONCLUSIONS
  Our study demonstrated that HTS is not suitable for treating UHS when compared to NFR and NS. Goats treated with NFR had superior values for all UHS features, including hemoglobin, pH, blood pressure, and bleeding time, compared to those treated with HTS and NS. Pre-hospital field treatment with NS or HTS may worsen the condition until surgical repair is accomplished.
authors.affiliation: Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran. m_saeedi@tums.ac.ir.
authors.forename: Morteza
authors.initials: M
authors.lastname: Saeedi
authors.affiliation: Department of Emergency Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Houman
authors.initials: H
authors.lastname: Hajiseyedjavadi
authors.affiliation: Department of Emergency Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Samad Shams
authors.initials: SS
authors.lastname: Vahdati
authors.affiliation: Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Vahid
authors.initials: V
authors.lastname: Eslami
authors.affiliation: Department of Emergency Medicine, Aja University of Medical Sciences, Tehran, Iran.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mokhtarpour
authors.affiliation: Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Momeni
authors.affiliation: Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Farnia
authors.affiliation: Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Nima Hafezi
authors.initials: NH
authors.lastname: Nejad
mesh_terms: D000818:Animals; D001794:Blood Pressure; D005440:Fluid Therapy / Q000379:methods; D006041:Goats; D006339:Heart Rate; D008297:Male; D023421:Models, Animal; D011897:Random Allocation; D012151:Resuscitation; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage*; D012771:Shock, Hemorrhagic / Q000628:therapy*; D012965:Sodium Chloride / Q000008:administration & dosage*
chemical_list: D012462:Saline Solution, Hypertonic; D012965:Sodium Chloride