COMPARISON OF 7.5-PERCENT NACL 6-PERCENT DEXTRAN-70 RESUSCITATION OF HEMORRHAGE BETWEEN EUHYDRATED AND DEHYDRATED SHEEP

被引:10
作者
SONDEEN, JL [1 ]
GUNTHER, RA [1 ]
DUBICK, MA [1 ]
机构
[1] UNIV CALIF DAVIS,DEPT SURG,DAVIS,CA 95616
来源
SHOCK | 1995年 / 3卷 / 01期
关键词
D O I
10.1097/00024382-199503010-00011
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
7.5% NaCI/6% dextran-70 (HSD) has been shown to be an effective, small volume resuscitation fluid following hemorrhage (HEM) in euhydrated (E) sheep. However, there is controversy whether hypertonic solutions would be effective in dehydrated (D) animals. Therefore, we used two groups (E and 4 days D) of chronically instrumented ewes to evaluate the responses to HSD following HEM. All sheep were bled and maintained at 50 mmHg mean arterial pressure (MAP) for 2 h, then resuscitated with a 4 mL/kg bolus of HSD. Dehydration did not affect baseline MAP, heart rate (HR), or total peripheral resistance (TPR), whereas cardiac output (CO: E, 5.28 +/- 31; D, 4.00 +/- 31 L/min), stroke volume (SV: E, 61 +/- 4; D, 44 +/- 4 mL/beat), urine flow rate (V: E, .51 +/- 11; D, .34 +/- .07 mL/min), and sodium excretion (UNaV: E, 22 +/- 8; D, 6 +/- 2 mu Eq/min) were reduced and plasma sodium (P-Na: E, 150 +/- 3; D, 157 +/- 2 mEq/L) and protein (PTP E, 7.8 +/- 1; D, 8.8 +/- .6 g/dl) were elevated. The only difference between groups during HEM were HR (E, 98 +/- 8; D, 150 +/- 17 bpm), SV (E, 31 +/- 3; D, 14 +/- 2), and TPR (E, 23 +/- 2; D, 32 +/- 3). Resuscitation with HSD restored MAP (E, 92 +/- 3; D, 92 +/- 2), CO (E, 6.2 +/- .3; D, 4.2 +/- .2), and TPR (E, 15 +/- 1; D, 23 +/- 1) to baseline values. SV was increased above hemorrhage values but was not restored to baseline values in either group (E, 50 +/- 7; D, 27 +/- 3). HR increased further following HSD (E, 143 +/- 11; D, 158 +/- 5). P-Na was raised 10 and 16 mEq/L in the E and D sheep, respectively, following HSD infusion, but no adverse effects associated with elevated P-Na were observed in either group. Thus, HSD was effective in restoring MAP, CO, and TPR to baseline values in D sheep but it was at the expense of a lower SV and a higher HR than in E sheep.
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页码:63 / 68
页数:6
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