title: Hypertonic Saline Dextran Ameliorates Organ Damage in Beagle Hemorrhagic Shock.
abstract: OBJECTIVE
  The goal of this study was to investigate the effect of hypertonic saline with 6% Dextran-70 (HSD) resuscitation on organ damage and the resuscitation efficiency of the combination of HSD and lactated ringers (LR) in a model of hemorrhage shock in dogs.
  
  
  METHODS
  Beagles were bled to hold their mean arterial pressure (MAP) at 50 ± 5 mmHg for 1 h. After hemorrhage, beagles were divided into three groups (n = 7) to receive pre-hospital resuscitation for 1 h (R1): HSD (4 ml/kg), LR (40 ml/kg), and HSD+LR (a combination of 4 ml/kg HSD and 40 ml/kg LR). Next, LR was transfused into all groups as in-hospital resuscitation (R2). After two hours of observation (R3), autologous blood was transfused. Hemodynamic responses and systemic oxygenation were measured at predetermined phases. Three days after resuscitation, the animals were sacrificed and tissues including kidney, lung, liver and intestinal were obtained for pathological analysis.
  
  
  RESULTS
  Although the initial resuscitation with HSD was shown to be faster than LR with regard to an ascending MAP, the HSD group showed a similar hemodynamic performance compared to the LR group throughout the experiment. Compared with the LR group, the systemic oxygenation performance in the HSD group was similar but showed a lower venous-to-arterial CO2 gradient (Pv-aCO2) at R3 (p < 0.05). Additionally, the histology score of the kidneys, lungs and liver were significantly lower in the HSD group than in the LR group (p < 0.05). The HSD+LR group showed a superior hemodynamic response but higher extravascular lung water (EVLW) and lower arterial oxygen tension (PaO2) than the other groups (p < 0.05). The HSD+LR group showed a marginally improved systemic oxygenation performance and lower histology score than other groups.
  
  
  CONCLUSIONS
  Resuscitation after hemorrhagic shock with a bolus of HSD showed a similar hemodynamic response compared with LR at ten times the volume of HSD, but HSD showed superior efficacy in organ protection. Our findings suggest that resuscitation with the combination of HSD and LR in the pre-hospital setting is an effective treatment.
authors: Institute of Transfusion Medicine, Academy of Military Medical Sciences, No. 27th Taiping Road, HaiDian, Beijing, China.
authors: Jing-xiang
authors: JX
authors: Zhao
authors: Institute of Transfusion Medicine, Academy of Military Medical Sciences, No. 27th Taiping Road, HaiDian, Beijing, China.
authors: Bo
authors: B
authors: Wang
authors: Institute of Transfusion Medicine, Academy of Military Medical Sciences, No. 27th Taiping Road, HaiDian, Beijing, China.
authors: Guo-xing
authors: GX
authors: You
authors: Institute of Transfusion Medicine, Academy of Military Medical Sciences, No. 27th Taiping Road, HaiDian, Beijing, China.
authors: Ying
authors: Y
authors: Wang
authors: Institute of Transfusion Medicine, Academy of Military Medical Sciences, No. 27th Taiping Road, HaiDian, Beijing, China.
authors: Gan
authors: G
authors: Chen
authors: Institute of Transfusion Medicine, Academy of Military Medical Sciences, No. 27th Taiping Road, HaiDian, Beijing, China.
authors: Quan
authors: Q
authors: Wang
authors: Emergency department, Chinese People's Liberation Army 307 hospital, No. 8th Dongda Street, Fengtai, Beijing, China.
authors: Xi-gang
authors: XG
authors: Zhang
authors: Institute of Transfusion Medicine, Academy of Military Medical Sciences, No. 27th Taiping Road, HaiDian, Beijing, China.
authors: Lian
authors: L
authors: Zhao
authors: Institute of Transfusion Medicine, Academy of Military Medical Sciences, No. 27th Taiping Road, HaiDian, Beijing, China.
authors: Hong
authors: H
authors: Zhou
authors: Science and Technology department, Academy of Military Medical Sciences, No. 27th Taiping Road, HaiDian, Beijing, China.
authors: Yue-zhong
authors: YZ
authors: He
mesh_terms: D000818:Animals; D003911:Dextrans / Q000494:pharmacology*; D004285:Dogs; D006439:Hemodynamics / Q000187:drug effects*; D008297:Male; D009102:Multiple Organ Failure / Q000503:physiopathology / Q000517:prevention & control; D012462:Saline Solution, Hypertonic / Q000494:pharmacology*; D012771:Shock, Hemorrhagic / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D003911:Dextrans; D012462:Saline Solution, Hypertonic