THE RENAL EFFECTS OF 7.5-PERCENT NACL-6-PERCENT DEXTRAN-70 VERSUS LACTATED RINGERS RESUSCITATION OF HEMORRHAGE IN DEHYDRATED SHEEP

A small volume of 7.5% NaCl/6% Dextran-70 (HSD) can rapidly expand the plasma volume, but concerns exist regarding its adverse effects on re nal function in the dehydrated state, Sheep were thirsted for 4 days ( 13% plasma volume contraction), and subjected to a fixed-pressure shoc k model (mean arterial pressure of 50 mmHg for 2 h), followed by resus citation with either HSD (4 mUkg) or lactated Ringer's solution (LR; 3 7 mL/kg). Mean arterial pressure was restored to 90%, cardiac output t o 125% and 120%, and plasma volume to 78% and 72% of baseline in LR an d HSD groups, respectively. Glomerular filtration rate improved to 100 % of baseline following HSD compared with 82% following LR, No signifi cant urinary 70,000 molecular weight dextran was observed, suggesting an intact renal glomerular membrane. These data suggest that small vol ume HSD resuscitation is effective, even with pre-existing dehydration . In addition, renal function is not compromised by HSD resuscitation of hemorrhaged, dehydrated animals.