HYPERGLYCEMIA AND SURVIVAL AFTER HEMORRHAGE

Objective: To assess the relation between the degree of hyperglycaemia during a standard haemorrhage and survival. Design: Prospective labor atory study Setting: University department of surgery, Sweden Material : 5 groups of 8-12 adult male Sprague-Dawley rats. Interventions: Diff erent degrees of hyperglycaemia were achieved in the 5 groups of rats (which had been starved for 24 hours) by infusion of the same amount o f 0.9% saline, or 5%, 10%, 20% or 30% glucose during a 48% standard ha emorrhage over 60 minutes. Blood glucose concentration and packed cell volume were measured every 30 minutes, and mean arterial pressure was monitored constantly. Main outcome measure: Survival at 7 days. Resul ts: Increases in blood glucose concentrations during haemorrhage,corre lated with plasma refill as indicated by reductions in packed cell vol ume (r = 0.85, p < 0.0001). Both increases in blood glucose concentrat ions and reductions in packed cell volume were inversely related to bl ood pressure during haemorrhage (p < 0.0001). The more glucose that wa s infused, the higher the blood glucose concentration and the better t he plasma refill during haemorrhage which correlated with improvement in the rate of survival at 7 days (p < 0.001). Conclusion: The ability to mount a hyperglycaemic response is an important prognostic factor in survial after experimental haemorrhage.