Objective: To test the hypothesis that controlled resuscitation can lead to
improved survival in otherwise fatal uncontrolled hemorrhage.
Methods: Uncontrolled hemorrhage was induced in 86 rats with a 25-gauge nee
dle puncture to the infrarenal aorta. Resuscitation 5 minutes after injury
was continued for 2 hours with lactated Ringer's solution (LR), 7.3% hypert
onic saline in 6% hetastarch (HH), or no fluid (NF). Fluids infused at 2 mL
.kg(-1) min(-1) were turned on or off to maintain a mean arterial pressure
(MAP) of 40, 80, or 100 mm Hg in six groups: NF, LR 40, LR 80, LR 100, HH 8
0, and HH 80. Blood loss was measured before and after 1 hour of resuscitat
ion.
Results: Survival was improved with fluids. Preresuscitation blood loss was
similar in all groups, NF rats did not survive 4 hours. After 72 hours, LR
80 rats (80%) and HIT 40 rats (67%) showed improved survival over NF rats
(0%) (p < 0.05). Rebleeding increased with MAP. Attempts to restore normal
MAP (LR 100) led to increased blood loss and mortality.
Conclusion: Controlled resuscitation leads to increased survival compared w
ith no fluids or standard resuscitation, Fluid type affects results. Contro
lled fluid use should be considered when surgical care is not readily avail
able.