L. Riddez et al., CENTRAL AND REGIONAL HEMODYNAMICS DURING UNCONTROLLED BLEEDING USING HYPERTONIC SALINE DEXTRAN FOR RESUSCITATION, Shock, 10(3), 1998, pp. 176-181
Citations number
29
Categorie Soggetti
Peripheal Vascular Diseas","Emergency Medicine & Critical Care",Hematology,Surgery
The effects of hypertonic (7.5%) saline/6% dextran 70 (HSD) on central
and regional hemodynamics were studied during uncontrolled intra-abdo
minal bleeding in 16 anesthetized pigs. Ultrasonic flow probes were pl
aced proximally and distally to an aortic injury to indicate the incid
ence and extent of rebleeding after injecting 4 mt kg(-1) (N = 8) and
2.65 mL kg(-1) (N = 8) of HSD 10 min after the vascular injury was ind
uced. The initial aortic bleeding reduced the blood flow rates to 71%
of baseline in the skin, 53% in the splanchnic region, 42% in the uppe
r aorta, and 15% in the kidney. Cardiac output dropped to 46% and the
mean arterial pressure to 57% of baseline. The injection of HSD was fo
llowed by a prompt increase in all blood flow rates, but rebleeding st
arted within 2 min in 13 of the pigs (81%). A second period of rebleed
ing occurred in six of them. The rebleeding averaged 300 mL, which is
62% of the blood lost when the aortic injury was induced, There was no
significant difference between the treatment groups with respect to t
hese blood losses or to the oxygen consumption, which was not restored
by HSD. Five animals in each treatment group died after about 70 min,
while the remaining six pigs (38%) survived the 120 min study period.
These results suggest that HSD in the recommended dose, and even two-
thirds thereof, promotes rebleeding when given shortly after a low ene
rgy intra-abdominal aortic injury. The fluid seems to have no benefici
al effect on this type of uncontrolled hemorrhage.