INTRAOSSEOUS INFUSION OF A SMALL-VOLUME OF HYPEROSMOTIC FLUID INCREASES MEAN ARTERIAL-PRESSURE AND LESSENS THE CATECHOLAMINE RESPONSE IN PIGS WITH HEMORRHAGIC-SHOCK

Objective: To measure the plasma catecholamine concentrations during a n episode of haemorrhagic shock treated by intraosseous infusion of a small volume of hyperosmotic fluid in a standardised porcine model. De sign. Randomised open study. Setting: University hospital, Norway. Mat erial: 14 piglets. Interventions: Two groups of piglets (n = 7 each) w ere anaesthetised with ketamine and bled to a mean arterial pressure o f 40 mm Hg. After 30 minutes the animals were randomised to receive 10 0 ml of either hyperosmotic (2.4 mol/l) or iso-osmotic (0.29 mol/l) fl uid (equal volumes of glucose and sodium chloride) into the tibial bon e marrow. Main outcome measures: Short term (70 minutes) observation o f changes in haemodynamic, biochemical and hormonal variables. Results : The hyperosmotic infusion significantly improved the circulation (me an arterial pressure and cardiac index) compared with the iso-osmotic infusion (p < 0.05). The increased plasma catecholamine concentrations returned to the reference ranges 20 minutes after the hyperosmotic in fusion, and were significantly different (p < 0.05) from the catechola mine concentrations observed in the iso-osmotic treatment group. Concl usion: Intraosseous hyperosmotic resuscitation increases the circulato ry performance and reduces the plasma catecholamine concentrations dur ing haemorrhagic shock in pigs.