Resuscitation of Intraoperative Hypovolemia: Comparison of Normal Saline and Hyperosmotic/Hypertonic Solutions in Swine.

摘要

We compared a hypertonic solution (7.5% NaCl in 6% Dextran-70, HSD) with isotonic saline (0.9% NaCl, NS) for treatment of intraoperative hypovolemia. Fourteen pigs anesthetized with isofluorane underwent a left thoracotomy, followed by hemorrhage for one hour to reduce mean arterial pressure to 45 mmHg. A continuous infusion of either solution was then initiated and the flow rate adjusted to restore and maintain thoracic descending aortic blood flow at baseline levels during a subsequent two-hour period. Full resuscitation to initial values of aortic blood flow was achieved with both regimens, but the NS group required larger volumes and sodium loads to maintain hemodynamic values. NS resuscitation produced increases in right heart preload (central venous pressure), and afterload (pulmonary artery pressure), resulting in increased right ventricular work.