LOW-DOSE HYPERTONIC SALINE (NACL 8.0-PERCENT) TREATMENT OF UNCONTROLLED ABDOMINAL HEMORRHAGE - EFFECTS ON ARTERIAL VERSUS VENOUS INJURY

The present study compared hemodynamic response to hypertonic saline ( HTS; NaCl 8.0%) treatment of uncontrolled hemorrhage from a stab injur y in the abdominal aorta (A) or vena cava (V), respectively. The hypot hesis was challenged that adverse effects of HTS treatment is dependen t on the pressure load in the lesioned vessel. Uncontrolled hemorrhage was produced in anesthetized rats by vessel puncture with a syringe n eedle. After 10 min of hemorrhage, subjects were randomized to HTS inf usion, 2.0 mL/kg i.v. given at .4 mL/min (AHTS, n = 10 and VHTS, n = 1 0), or to no treatment (AC, n = 12 and VC, n = 7). Mean arterial press ure (MAP), heart rate, plasma electrolytes, protein, and hematocrit we re recorded continuously for 240 min. HTS treatment produced MAP eleva tion but did not influence the final outcome in either A or V lesions. Thus, evidence of worsened outcome related to HTS treatment was not c onfirmed. However, one-half of all subjects with arterial hemorrhage d ied, compared to only 1 of 17 subjects with venous hemorrhage. Spontan eous MAP recovery during hemorrhage, and MAP response to HTS treatment , were shown to have predictive value for survival.