Hemodynamic response of modified fluid gelatin compared with lactated ringer's solution for volume expansion in emergency resuscitation of hypovolemic shock patients: Preliminary report of a prospective, randomized trial

The objective of this study was to compare the cardiac and hemodynamic resp onses to a rapid infusion of 1000 mi of modified fluid gelatin (group A) or 1000 mi of lactated Ringer's solution (group B) in emergency room patients suffering from shock, This prospective, randomized, open, noncrossover stu dy was performed at a medical center university hospital in a surgical resu scitation room in the emergency department. The subjects were 34 patients w ith either hypovolemic or neurogenic shock who were admitted to the emergen cy room. A resuscitation protocol according to Advanced Trauma Life Support (ATLS) with an additional central venous line or Swan-Ganz catheters for h emodynamic monitoring was used. Physical parameters and hemodynamic variabl es were measured at baseline and 15 minutes, 30 minutes, and 1 hour after t he infusion of each fluid. In both groups the mean arterial blood pressure (MAP), systolic and diastolic pressure, central venous pressure (CVP), and pulmonary artery occlusion pressure (PAOP) increased significantly, The CVP and PAOP increased significantly more in the modified fluid gelatin resusc itation group. In patients with traumatic or neurogenic shock due to acute volume deficiency, there was significantly better hemodynamic improvement, judged by CVP and PAOP measurements using the modified fluid gelatin for vo lume replacement than with lactated Ringer's solution during the first hour of resuscitation.