PMID: 7536851Apr 1, 1995Paper

Hypertonic acetate dextran achieves high-flow-low-pressure resuscitation of hemorrhagic shock

The Journal of Trauma
T T NguyenG C Kramer

Abstract

For resuscitation of hemorrhagic hypovolemia, we compared the effectiveness of (1) isotonic lactated Ringer's solution (LRS), (2) 2400 mOsm of 7.5% NaCl:6% dextran 70 (HSD), and (3) 2400 mOsm of 7.9% sodium acetate:1.9% NaCl:6% dextran 70 (HAD). In six randomized, blinded experiments for each solution, conscious instrumented adult sheep were hemorrhaged by removing approximately 1.8 L (42 +/- 3 mL/kg) of blood, while maintaining the mean arterial pressure (MAP) at 50 mm Hg for 2 hours. Test solutions were infused as needed to restore the cardiac index to baseline. Volume requirements with HAD (236 +/- 29 mL) and HSD (244 +/- 39 mL) were significantly less (p < 0.05) than LRS (3463 +/- 234 mL). Mean arterial pressure was normalized with HSD and LRS, but not with HAD, which resulted in MAPs of 20 to 25 mm Hg less than baseline resulting from a reduced peripheral resistance. Oxygen delivery, however, was significantly higher with HAD during the resuscitation period. Acid-base balance (pH) and oxygen consumption were normalized within 5 minutes of infusion only with HAD. Small-volume infusion with HAD resulting in "high-flow-low-pressure" resuscitation may offer unique hemodynamic and metabolic advantages for the initial treatment ...Continue Reading

References

Jun 1, 1988·The Journal of Trauma·D GrossM M Krausz
Dec 1, 1985·The Journal of Surgical Research·G J SmithJ W Holcroft
May 1, 1973·American Journal of Surgery·J A MoylanA D Mason
Dec 1, 1973·American Journal of Surgery·W W MonafoV H Ayvazian
Feb 1, 1971·The American Journal of Physiology·S GazitùaF J Haddy
Apr 1, 1969·The American Journal of Physiology·K WildenthalJ H Mitchell

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Citations

Feb 1, 1996·Critical Care Medicine·W C ShoemakerL Wiklund
Aug 9, 2002·Anesthesiology Clinics of North America·Eric Bedell, Donald S Prough
Jun 11, 1999·The American Journal of Physiology·S R FischerG C Kramer
Jan 1, 1997·Artificial Cells, Blood Substitutes, and Immobilization Biotechnology·L F Poli de FigueiredoG C Kramer

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