title: Does the infusion rate of fluid affect rapidity of mean arterial pressure restoration during controlled hemorrhage.
abstract: OBJECTIVE
  This study aimed to compare 2 fluid infusion rates of lactated Ringer (LR) and hydroxyethyl starch (HES) 130/0.4 on hemodynamic restoration at the early phase of controlled hemorrhagic shock.
  
  
  METHODS
  Fifty-six anesthetized and ventilated piglets were bled until mean arterial pressure (MAP) reached 40 mm Hg. Controlled hemorrhage was maintained for 30 minutes. After this period, 4 resuscitation groups were studied (n=14 for each group): HES infused at 1 or 4mL/kg per minute or LR1 infused at 1 or 4mL/kg per minute until baseline MAP was restored. Hemodynamic assessment using PiCCO monitoring and biological data were collected.
  
  
  RESULTS
  Time to restore baseline MAP ±10% was significantly lower in LR4 group (11±11 minutes) compared to LR1 group (41±25 minutes) (P=.0004). Time to restore baseline MAP ±10% was significantly lower in HES4 group (4±3 minutes) compared to HES1 (11±4 minutes) (P=.0003). Time to restore baseline MAP ±10% was significantly lower with HES vs LR whatever the infusion rate. No statistically significant difference was observed in cardiac output, central venous saturation, extravascular lung water, and arterial lactate between 4 and 1 mL/kg per minute groups.
  
  
  CONCLUSIONS
  In this controlled hemorrhagic shock model, a faster infusion rate (4 vs 1mL/kg per minute) significantly decreased the time for restoring baseline MAP, regardless of the type of infused fluid. The time for MAP restoration was significantly shorter for HES as compared to LR whatever the fluid infusion rate.
authors.affiliation: Department of Anesthesiology, Emergency and Critical Care Medicine, Nimes University Hospital, 30029 Nîmes, France; Physiology Department, EA 2992, Faculté de Médecine de Nîmes, Université Montpellier 1, 30029 Nîmes, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Roger
authors.affiliation: Department of Anesthesiology, Emergency and Critical Care Medicine, Nimes University Hospital, 30029 Nîmes, France; Physiology Department, EA 2992, Faculté de Médecine de Nîmes, Université Montpellier 1, 30029 Nîmes, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Louart
authors.affiliation: Department of Anesthesiology, Emergency and Critical Care Medicine, Nimes University Hospital, 30029 Nîmes, France; Physiology Department, EA 2992, Faculté de Médecine de Nîmes, Université Montpellier 1, 30029 Nîmes, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Louart
authors.affiliation: Department of Anesthesiology, Emergency and Critical Care Medicine, Nimes University Hospital, 30029 Nîmes, France; Physiology Department, EA 2992, Faculté de Médecine de Nîmes, Université Montpellier 1, 30029 Nîmes, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Bobbia
authors.affiliation: Department of Anesthesiology, Emergency and Critical Care Medicine, Nimes University Hospital, 30029 Nîmes, France.
authors.forename: Pierre-Geraud
authors.initials: PG
authors.lastname: Claret
authors.affiliation: Physiology Department, EA 2992, Faculté de Médecine de Nîmes, Université Montpellier 1, 30029 Nîmes, France.
authors.forename: Antonia
authors.initials: A
authors.lastname: Perez-Martin
authors.affiliation: Department of Anesthesiology, Emergency and Critical Care Medicine, Nimes University Hospital, 30029 Nîmes, France; Physiology Department, EA 2992, Faculté de Médecine de Nîmes, Université Montpellier 1, 30029 Nîmes, France. Electronic address: laurent.muller@chu-nimes.fr.
authors.forename: Laurent
authors.initials: L
authors.lastname: Muller
authors.affiliation: Department of Anesthesiology, Emergency and Critical Care Medicine, Nimes University Hospital, 30029 Nîmes, France; Physiology Department, EA 2992, Faculté de Médecine de Nîmes, Université Montpellier 1, 30029 Nîmes, France.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Lefrant
mesh_terms: D000818:Animals; D062186:Arterial Pressure; D002302:Cardiac Output; D005440:Fluid Therapy / Q000379:methods*; D006439:Hemodynamics; D006470:Hemorrhage / Q000628:therapy*; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage*; D007262:Infusions, Intravenous / Q000379:methods*; D007552:Isotonic Solutions / Q000008:administration & dosage*; D008297:Male; D010952:Plasma Substitutes / Q000008:administration & dosage*; D012151:Resuscitation; D000077325:Ringer's Lactate; D013552:Swine
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D000077325:Ringer's Lactate