Document Detail


Resuscitation from hemorrhagic shock with hypertonic saline or lactated Ringer's (effect on the pulmonary and systemic microcirculations).
MedLine Citation:
PMID:  6839427     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We compared the use of hypertonic salt solution (300 mEq Na/liter) with Ringer's lactate as an initial resuscitation fluid for the treatment of hemorrhagic shock. We monitored vascular pressures and cardiac output as well as microvascular function using chronic lymph fistulae in the lung and soft tissues to reflect transvascular fluid and protein flux. Seven unanesthetized sheep were bled to an aortic pressure of 50 mm Hg (2 hours) on two occasions 4-5 days apart, and were resuscitated initially with either lactated Ringer's (LR) or hypertonic saline (HS) to restore left atrial pressure to baseline. This was followed later by the blood return. We found that cardiac output with HS was significantly increased over that with LR, 8.9 +/- 1.8, compared with 6.0 +/- 1.1, in the immediate postresuscitation period with comparable volumes in both groups. Urine output was increased twofold with HS over LR. The initial pulmonary hypertension seen with LR was eliminated with HS. Lymph flow in lung and soft tissue increased to a comparable degree in both groups, the increase being explained by the degree of plasma hypoproteinemia which was present. We conclude that HS increases cardiac output with less net fluid, decreases pulmonary vascular resistance, and does not result in more edema formation when compared with lactated Ringer's as an initial fluid for treatment of hemorrhagic shock.
Authors:
M Nerlich; R Gunther; R H Demling
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulatory shock     Volume:  10     ISSN:  0092-6213     ISO Abbreviation:  Circ. Shock     Publication Date:  1983  
Date Detail:
Created Date:  1983-06-23     Completed Date:  1983-06-23     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0414112     Medline TA:  Circ Shock     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  179-88     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Proteins / analysis
Blood Transfusion
Blood Volume / drug effects
Cardiac Output / drug effects
Isotonic Solutions / administration & dosage,  therapeutic use*
Lung / blood supply
Lymphatic System / physiopathology
Microcirculation / drug effects
Plasma Substitutes / administration & dosage,  therapeutic use
Resuscitation / methods*
Saline Solution, Hypertonic / administration & dosage,  therapeutic use*
Sheep
Shock, Hemorrhagic / drug therapy*,  physiopathology,  therapy
Sodium Chloride / therapeutic use*
Grant Support
ID/Acronym/Agency:
HL07013-06/HL/NHLBI NIH HHS; HL25403/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Blood Proteins; 0/Isotonic Solutions; 0/Plasma Substitutes; 0/Saline Solution, Hypertonic; 0/crystalloid solutions; 7647-14-5/Sodium Chloride; 8022-63-7/Ringer's lactate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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