Superiority of Hypertonic Saline/Dextran Over Hypertonic Saline during the First 30 Minutes of Resuscitation Following Hemorrhagic Hypotension in Conscious Swine.

摘要

We compared the effectiveness of intravenous administration of hypertonic saline/dextran (7.5% NaCl in 6% Dextran-70, n=6) to hypertonic saline alone (7.5% NaCl, n=8) in rectifying the detrimental effects of hemorrhage on cardiovascular function. Chronically instrumented conscious swine were hemorrhaged 37.5 ml/kg over 60 min in an exponential manner. If untreated, this model is 100% lethal within 60 min of hemorrhage completion. Immediately after hemorrhage, the swine were administered hypertonic saline/dextran or hypertonic saline at 4 ml/kg, and functional variables were measured before and at 5, 15, and 30 min following treatment. Hypertonic saline/dextran produced a significantly greater plasma volume expansion than hypertonic saline alone (13.6 compared to 9.9 ml/kg). This expansion, furthermore, was sustained in pigs receiving HSD, but regressed over 30 min in pigs receiving HS. In both treatments the cardiac index was increased, but to a greater extent with HSD, 104 ml/kg/min, compared to HS alone, 46 ml/kg/min. Oxygen delivery showed a trend similar to that of cardiac index, with HSD producing a greater improvement and the difference between groups again sustained over the 30 min. We conclude that resuscitation with HSD is superior to that of HS in improving cardiovascular function over the first 30 min after hemorrhage. (kt)