Hemodynamic effects of fluid resuscitation with 6% hydroxyethyl starch and whole blood in experimental hypovolemic shock in Beagle dogs

摘要

The short-term effects of 6% hydroxyethyl starch (HES) and whole blood (WB) resuscitations in hypovolemic shock (HS) on invasive and noninvasive hemodynamic variables were studied from the clinical point of view in 20 mature healthy male Beagle dogs. After anesthesia, the animals were randomly divided into 2 groups, HES (n = 10) and WB (n = 10), and were surgically instrumented with an arterial catheter and a thermodilution cardiac output catheter. For induction of HS, the right carotid artery was catheterized and approximately 40% of the blood volume was drawn over a period of 30 min, until a mean arterial blood pressure (MAP) of about 50 mmHg was reached. After that, the HES group received 6% HES and the WB group received autologous whole blood resuscitation (30 mL/kg/h). The measurement of hemodynamic variables was performed in normovolemic (baseline, BL), severe hypovolemic, and resuscitation state (from R1 to R4 at an interval of 30 min). Significant changes in some of the hemodynamic variables systolic arterial pressure (SAP), diastolic arterial pressure (DAP), MAP, central venous pressure (CVP), cardiac output (CO), cardiac index (CI), stroke volume (SV), stroke volume index (SVI), oxygen delivery (DO_2), and oxygen consumption (VO_2) were observed during hypovolemic shock and resuscitation, which could reflect the condition of the patient. Resuscitation with WB seemed to resolve the hemodynamic variables to or above BL, whereas that with HES could resolve most but not all of the hemodynamic variables. The WB was found to be superior to restore the hemodynamic variable to the BL or above in comparison to that of the HES, for the clinical management of HS in dogs. The findings of this study suggest that dogs in HS can be successfully resuscitated with HES and WB.