Uncontrolled hemorrhage from parenchymal injury: Is resuscitation helpful?

被引:35
作者
Matsuoka, T
Hildreth, J
Wisner, DH
机构
[1] UNIV CALIF DAVIS, SCH MED, DEPT SURG, SACRAMENTO, CA 95817 USA
[2] OSAKA UNIV, DEPT TRAUMATOL, OSAKA, JAPAN
来源
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE | 1996年 / 40卷 / 06期
关键词
D O I
10.1097/00005373-199606000-00009
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Fluid resuscitation increases blood pressure and may increase hemorrhage, We tested this hypothesis in a model of liver injury, After standardized injury, rats were randomized into four groups: no resuscitation (NR, n = 30), small volume lactated Ringer's solution (SVLR, 4 mL/kg, n = 30), large volume lactated Ringer's solution (LVLR, 24 mL/kg, n = 30), and hypertonic saline (HS, 4 mL/kg, n = 30), Terminal circulating volume was estimated using controlled hemorrhage experiments, Survival times and mortality rates were significantly lower in HS animals (10%) than in NR (50%) or SVLR (47%) animals, Blood pressure was significantly higher after HS, and this difference was sustained, Intraperitoneal blood volume was significantly higher with HS (26.0 +/- 0.7 mL/kg) and LVLR (26.9 +/- 0.6 mL/kg) compared with NR (21.5 +/- 0.7 mL/kg) and SVLR (22.5 +/- 0.7 mL/kg), Estimated terminal blood volume was significantly decreased in LVLR (29.3 +/- 0.6 mL/kg) compared with NR (33.3 +/- 0.7 mL/kg), SVLR (33.7 +/- 0.8 mL/kg), and HS (31.7 +/- 0.7 mL/kg). Conclusion: Vigorous resuscitation increases bleeding from solid viscus injury, Small volume HS improves blood pressure and survival compared with no resuscitation, Results of large vessel hemorrhage models may not apply to parenchymal viscus injury.
引用
收藏
页码:915 / 921
页数:7
相关论文
共 24 条
[1]  
*AM COLL SURG, 1993, ADV TRAUM LIF SUPP
[2]   COMBINED HEMORRHAGIC-SHOCK AND HEAD-INJURY - EFFECTS OF HYPERTONIC SALINE (7.5-PERCENT) RESUSCITATION [J].
BATTISTELLA, FD ;
WISNER, DH .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1991, 31 (02) :182-188
[3]   IMMEDIATE VERSUS DELAYED FLUID RESUSCITATION FOR HYPOTENSIVE PATIENTS WITH PENETRATING TORSO INJURIES [J].
BICKELL, WH ;
WALL, MJ ;
PEPE, PE ;
MARTIN, RR ;
GINGER, VF ;
ALLEN, MK ;
MATTOX, KL .
NEW ENGLAND JOURNAL OF MEDICINE, 1994, 331 (17) :1105-1109
[4]   USE OF HYPERTONIC SALINE DEXTRAN VERSUS LACTATED RINGERS SOLUTION AS A RESUSCITATION FLUID AFTER UNCONTROLLED AORTIC HEMORRHAGE IN ANESTHETIZED SWINE [J].
BICKELL, WH ;
BRUTTIG, SP ;
MILLNAMOW, GA ;
OBENAR, J ;
WADE, CE .
ANNALS OF EMERGENCY MEDICINE, 1992, 21 (09) :1077-1085
[5]  
CAPONE AC, 1995, J AM COLL SURGEONS, V180, P49
[6]   ROLE OF INTESTINAL FLUID IN RESTITUTION OF BLOOD-VOLUME AND PLASMA-PROTEIN AFTER HEMORRHAGE IN AWAKE RATS [J].
DARLINGTON, DN ;
JONES, RO ;
MAGNUSON, TA ;
GANN, DS .
AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY, 1995, 268 (03) :R715-R722
[7]  
DEFELIPPE J, 1980, LANCET, V2, P1002
[8]   IS HYPERTONIC SALINE RESUSCITATION SAFE IN UNCONTROLLED HEMORRHAGIC-SHOCK [J].
GROSS, D ;
LANDAU, EH ;
ASSALIA, A ;
KRAUSZ, MM .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1988, 28 (06) :751-756
[9]  
GROSS D, 1990, SURG GYNECOL OBSTET, V170, P106
[10]   QUANTITATIVE MEASUREMENT OF BLEEDING FOLLOWING HYPERTONIC SALINE THERAPY IN UNCONTROLLED HEMORRHAGIC-SHOCK [J].
GROSS, D ;
LANDAU, EH ;
KLIN, B ;
KRAUSZ, MM .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1989, 29 (01) :79-83