3% NaCl adenosine, lidocaine, Mg2+ (ALM) bolus and 4 hours "drip" infusion reduces noncompressible hemorrhage by 60% in a rat model

The Journal of Trauma and Acute Care Surgery
Hayley L Letson, Geoffrey P Dobson

Abstract

Noncompressible torso hemorrhage is the leading cause of potentially survivable trauma in far-forward combat environments. Our aim was to examine the effect of small-volume 3% NaCl adenosine, lidocaine, and Mg (ALM) bolus and 0.9% NaCl/ALM "drip" on survivability and cardiac/gut/kidney function in a rat model of hepatic hemorrhage and shock. Male Sprague-Dawley rats (428 ± 4 g) were anesthetized and randomly assigned to one of five groups (n = 16): (1) Sham, (2) No treatment, (3) Saline controls, (4) ALM therapy, and (5) Hextend. Animals were ventilated, instrumented with single or double laparotomy for tissue probe insertion, and hemorrhage induced by liver resection. After 15 minutes, a single 3% NaCl ± ALM bolus (0.7 ml/kg) was injected IV (phase 1) and after 60 minutes, 4 hours 0.9% NaCl ± ALM stabilization "drip" (0.5 ml/kg/h) was administered (phase 2), with 1-hour monitoring. Mortality for Shams (no resection) was 0% (25%); No treatment, 87.5% (100%); Saline controls, 37.5% (75%); ALM therapy, 0% (25%), and Hextend, 87.5% (100%) (double laparotomy in parentheses). Hextend-treated animals died during the first 20 minutes of phase 2. A single ALM bolus during phase 1 led to a 2.4-fold higher cardiac output and improved hem...Continue Reading

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Citations

Oct 19, 2017·The Journal of Trauma and Acute Care Surgery·Lusha XiangKathy L Ryan
Mar 20, 2018·The Journal of Trauma and Acute Care Surgery·Hayley L Letson, Geoffrey P Dobson
Jun 30, 2019·Scientific Reports·Hayley L LetsonGeoffrey P Dobson
Feb 9, 2021·Frontiers in Immunology·Geoffrey P DobsonJodie L Morris
Aug 2, 2020·International Journal of Surgery·Geoffrey P Dobson
Jul 27, 2021·Frontiers in Veterinary Science·Armi Pigott, Elke Rudloff

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