RESUSCITATION FROM HYPOVOLEMIA IN SWINE WITH INTRAOSSEOUS INFUSION OFA SATURATED SALT-DEXTRAN SOLUTION

Prehospital fluid resuscitation of traumatic injury is limited by diff iculty in delivering large volumes of fluid in the field and time dela ys associated with gaining vascular access. We addressed these limitat ions in 14 anesthetized swine by evaluating a highly efficient volume expander, a near-saturated salt-dextran solution (SSD) administered th rough a new device, which gains vascular access via intraosseous (10) infusion into the sternal bone marrow. After a steady-state baseline w as achieved, all animals were hemorrhaged to 45 mm Hg for one hour. Ha lf of the hemorrhaged animals were infused intraosseously with either normal saline (NS) or SSD until cardiac output was restored to the bas eline value. No further infusion was given and animals were monitored for 2 hours. Both regimens were able to restore cardiac output to the baseline value, but only 1.3 +/- 0.1 mL/kg of SSD was required vs. 31. 6 +/- 6.3 mL/kg for NS. In addition, cardiac output was better sustain ed after 2 hours with SSD than with NS. No deleterious effects of 10 i nfusion of SSD were observed. From the improvement in cardiovascular v ariables and the lack of significant sternal or pulmonary pathologic p erturbations, these data suggest that 10 infusion of SSD can effective ly treat hypovolemia and may allow field treatment when logistic consi derations make conventional resuscitation impractical.