Small Volume Resuscitation of Hypovolemic Shock.

摘要

Studies of unanesthetized sheep and anesthetized rats were performed to evaluate the effectiveness of hypertonic saline dextran formulations. Based on presented data we conclude: 1) Hypertonic 7.5% saline 6% dextran (HSD) can safely and effectively be delivered via peripheral vessels; 2) Hypertonic saline hetastarch works almost as well as hypertonic saline dextran; 3) Higher concentrations of dextran added to hypertonic saline increase the volume expansion and cardiovascular improvement; 4) NMR shows that falls in ATP occur very late in kidney, brain and skeletal muscle during hemorrhagic chock. The P-Cr/Pi ratio decreases in shock and was decreased more in animals that were in irreversible shock; 5) Multiple small bolus infusions (1 ml/kg) of HSD can be used for resuscitation; 6) A 29% NaCl/24% dextran solution given in a volume of 40 ml fully resuscitated a 1.6 liter hemorrhage; 7) Large isotonic resuscitation and small volume hypertonic resuscitation resulted in similar distributions of cardiac output; and 8) HSD resuscitation was found safe and effective in dehydrated animals; although dehydration causes animals to tolerate less blood loss. (KR)