Small-volume resuscitation from hemorrhagic shock in dogs: Effects on systemic hemodynamics and systemic blood flow

Donald Prough, J. M. Whitley, C. L. Taylor, D. D. Deal, Douglas Dewitt

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Background and Methods: This study compared canine systemic hemodynamics and organ blood flow (radioactive microsphere technique) after resuscitation with 0.8% saline (Na+ 137 mEq/L), 7.2% hypertonic saline (Na+ 1233 mEq/L), 20% hydroxyethyl starch in 0.8% saline, or 20% hydroxyethyl starch in 7.2% saline, each in a volume approximating 15% of shed blood volume. Twenty-four endotracheally intubated mongrel dogs (18 to 24 kg) underwent a 30-min period of hemorrhagic shock, from time 0 to 30 min into the shock period, followed by fluid resuscitation. Data were collected at baseline, 15 min into the shock period, immediately after fluid infusion, 5 min after the beginning of resuscitation, and at 60-min intervals for 2 hr, (65 min after the beginning of resuscitation). The animals received one of four randomly assigned iv resuscitation fluids: saline (54 mL/kg), hypertonic saline (6.0 mL/kg), hydroxyethel starch (6.0 mL/kg) or hypertonic saline/hydroxyethyl starch (6.0 mL/kg). Results: Mean arterial pressure increased in all groups after resuscitation. Cardiac output increased with resuscitation in all groups, exceeding baseline in the saline and hypertonic saline/hydroxyethyl starch groups (p < .05 compared with hypertonic saline or hydroxyethyl starch). Sixty-five minutes after the beginning of resuscitation, cardiac output was significantly (p < .05) greater in either of the two colloid-containing groups than in the hypertonic saline group. After resuscitation, hypertonic saline and hydroxyethyl starch produced minimal improvements in hepatic arterial flow, hypertonic saline/hydroxyethyl starch increased hepatic arterial flow to near baseline levels, and saline markedly increased hepatic arterial flow to levels exceeding baseline (p < .05, saline vs. hydroxyethyl starch). One hundred twenty-five minuutes after the beginning of resuscitation, hepatic arterial flow had decreased in all groups; hepatic arterial flow in the hypertonic saline group had decreased to levels comparable with those during shock. Myocardial, renal, and brain blood flow were not significantly different between groups. Conclusions: Small-volume resuscitation with the combination of hypertonic saline/hydroxyethyl starch is comparable with much larger volumes of 0.8% saline, and is equal to hypertonic saline or hydroxyethyl starch in the ability to restore and sustain BP and improve organ blood flow after resuscitation from hemorrhagic shock.

Original languageEnglish (US)
Pages (from-to)364-372
Number of pages9
JournalCritical Care Medicine
Volume19
Issue number3
StatePublished - 1991
Externally publishedYes

Fingerprint

Hemorrhagic Shock
Resuscitation
Starch
Hemodynamics
Dogs
Liver
Shock
Cardiac Output
Renal Circulation
Colloids
Blood Volume
Microspheres
Canidae
Arterial Pressure

Keywords

  • Cardiac output
  • Colloids
  • Hemorrhagic
  • Hydroxyethyl starch
  • Intravenous fluid therapy
  • Liver circulation
  • Renal circulation
  • Resuscitation
  • Saline solution, hypertonic
  • Shock

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Small-volume resuscitation from hemorrhagic shock in dogs : Effects on systemic hemodynamics and systemic blood flow. / Prough, Donald; Whitley, J. M.; Taylor, C. L.; Deal, D. D.; Dewitt, Douglas.

In: Critical Care Medicine, Vol. 19, No. 3, 1991, p. 364-372.

Research output: Contribution to journalArticle

@article{3383618ebdfb41698d6e6df1e5a7078e,
title = "Small-volume resuscitation from hemorrhagic shock in dogs: Effects on systemic hemodynamics and systemic blood flow",
abstract = "Background and Methods: This study compared canine systemic hemodynamics and organ blood flow (radioactive microsphere technique) after resuscitation with 0.8{\%} saline (Na+ 137 mEq/L), 7.2{\%} hypertonic saline (Na+ 1233 mEq/L), 20{\%} hydroxyethyl starch in 0.8{\%} saline, or 20{\%} hydroxyethyl starch in 7.2{\%} saline, each in a volume approximating 15{\%} of shed blood volume. Twenty-four endotracheally intubated mongrel dogs (18 to 24 kg) underwent a 30-min period of hemorrhagic shock, from time 0 to 30 min into the shock period, followed by fluid resuscitation. Data were collected at baseline, 15 min into the shock period, immediately after fluid infusion, 5 min after the beginning of resuscitation, and at 60-min intervals for 2 hr, (65 min after the beginning of resuscitation). The animals received one of four randomly assigned iv resuscitation fluids: saline (54 mL/kg), hypertonic saline (6.0 mL/kg), hydroxyethel starch (6.0 mL/kg) or hypertonic saline/hydroxyethyl starch (6.0 mL/kg). Results: Mean arterial pressure increased in all groups after resuscitation. Cardiac output increased with resuscitation in all groups, exceeding baseline in the saline and hypertonic saline/hydroxyethyl starch groups (p < .05 compared with hypertonic saline or hydroxyethyl starch). Sixty-five minutes after the beginning of resuscitation, cardiac output was significantly (p < .05) greater in either of the two colloid-containing groups than in the hypertonic saline group. After resuscitation, hypertonic saline and hydroxyethyl starch produced minimal improvements in hepatic arterial flow, hypertonic saline/hydroxyethyl starch increased hepatic arterial flow to near baseline levels, and saline markedly increased hepatic arterial flow to levels exceeding baseline (p < .05, saline vs. hydroxyethyl starch). One hundred twenty-five minuutes after the beginning of resuscitation, hepatic arterial flow had decreased in all groups; hepatic arterial flow in the hypertonic saline group had decreased to levels comparable with those during shock. Myocardial, renal, and brain blood flow were not significantly different between groups. Conclusions: Small-volume resuscitation with the combination of hypertonic saline/hydroxyethyl starch is comparable with much larger volumes of 0.8{\%} saline, and is equal to hypertonic saline or hydroxyethyl starch in the ability to restore and sustain BP and improve organ blood flow after resuscitation from hemorrhagic shock.",
keywords = "Cardiac output, Colloids, Hemorrhagic, Hydroxyethyl starch, Intravenous fluid therapy, Liver circulation, Renal circulation, Resuscitation, Saline solution, hypertonic, Shock",
author = "Donald Prough and Whitley, {J. M.} and Taylor, {C. L.} and Deal, {D. D.} and Douglas Dewitt",
year = "1991",
language = "English (US)",
volume = "19",
pages = "364--372",
journal = "Critical Care Medicine",
issn = "0090-3493",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Small-volume resuscitation from hemorrhagic shock in dogs

T2 - Effects on systemic hemodynamics and systemic blood flow

AU - Prough, Donald

AU - Whitley, J. M.

AU - Taylor, C. L.

AU - Deal, D. D.

AU - Dewitt, Douglas

PY - 1991

Y1 - 1991

N2 - Background and Methods: This study compared canine systemic hemodynamics and organ blood flow (radioactive microsphere technique) after resuscitation with 0.8% saline (Na+ 137 mEq/L), 7.2% hypertonic saline (Na+ 1233 mEq/L), 20% hydroxyethyl starch in 0.8% saline, or 20% hydroxyethyl starch in 7.2% saline, each in a volume approximating 15% of shed blood volume. Twenty-four endotracheally intubated mongrel dogs (18 to 24 kg) underwent a 30-min period of hemorrhagic shock, from time 0 to 30 min into the shock period, followed by fluid resuscitation. Data were collected at baseline, 15 min into the shock period, immediately after fluid infusion, 5 min after the beginning of resuscitation, and at 60-min intervals for 2 hr, (65 min after the beginning of resuscitation). The animals received one of four randomly assigned iv resuscitation fluids: saline (54 mL/kg), hypertonic saline (6.0 mL/kg), hydroxyethel starch (6.0 mL/kg) or hypertonic saline/hydroxyethyl starch (6.0 mL/kg). Results: Mean arterial pressure increased in all groups after resuscitation. Cardiac output increased with resuscitation in all groups, exceeding baseline in the saline and hypertonic saline/hydroxyethyl starch groups (p < .05 compared with hypertonic saline or hydroxyethyl starch). Sixty-five minutes after the beginning of resuscitation, cardiac output was significantly (p < .05) greater in either of the two colloid-containing groups than in the hypertonic saline group. After resuscitation, hypertonic saline and hydroxyethyl starch produced minimal improvements in hepatic arterial flow, hypertonic saline/hydroxyethyl starch increased hepatic arterial flow to near baseline levels, and saline markedly increased hepatic arterial flow to levels exceeding baseline (p < .05, saline vs. hydroxyethyl starch). One hundred twenty-five minuutes after the beginning of resuscitation, hepatic arterial flow had decreased in all groups; hepatic arterial flow in the hypertonic saline group had decreased to levels comparable with those during shock. Myocardial, renal, and brain blood flow were not significantly different between groups. Conclusions: Small-volume resuscitation with the combination of hypertonic saline/hydroxyethyl starch is comparable with much larger volumes of 0.8% saline, and is equal to hypertonic saline or hydroxyethyl starch in the ability to restore and sustain BP and improve organ blood flow after resuscitation from hemorrhagic shock.

AB - Background and Methods: This study compared canine systemic hemodynamics and organ blood flow (radioactive microsphere technique) after resuscitation with 0.8% saline (Na+ 137 mEq/L), 7.2% hypertonic saline (Na+ 1233 mEq/L), 20% hydroxyethyl starch in 0.8% saline, or 20% hydroxyethyl starch in 7.2% saline, each in a volume approximating 15% of shed blood volume. Twenty-four endotracheally intubated mongrel dogs (18 to 24 kg) underwent a 30-min period of hemorrhagic shock, from time 0 to 30 min into the shock period, followed by fluid resuscitation. Data were collected at baseline, 15 min into the shock period, immediately after fluid infusion, 5 min after the beginning of resuscitation, and at 60-min intervals for 2 hr, (65 min after the beginning of resuscitation). The animals received one of four randomly assigned iv resuscitation fluids: saline (54 mL/kg), hypertonic saline (6.0 mL/kg), hydroxyethel starch (6.0 mL/kg) or hypertonic saline/hydroxyethyl starch (6.0 mL/kg). Results: Mean arterial pressure increased in all groups after resuscitation. Cardiac output increased with resuscitation in all groups, exceeding baseline in the saline and hypertonic saline/hydroxyethyl starch groups (p < .05 compared with hypertonic saline or hydroxyethyl starch). Sixty-five minutes after the beginning of resuscitation, cardiac output was significantly (p < .05) greater in either of the two colloid-containing groups than in the hypertonic saline group. After resuscitation, hypertonic saline and hydroxyethyl starch produced minimal improvements in hepatic arterial flow, hypertonic saline/hydroxyethyl starch increased hepatic arterial flow to near baseline levels, and saline markedly increased hepatic arterial flow to levels exceeding baseline (p < .05, saline vs. hydroxyethyl starch). One hundred twenty-five minuutes after the beginning of resuscitation, hepatic arterial flow had decreased in all groups; hepatic arterial flow in the hypertonic saline group had decreased to levels comparable with those during shock. Myocardial, renal, and brain blood flow were not significantly different between groups. Conclusions: Small-volume resuscitation with the combination of hypertonic saline/hydroxyethyl starch is comparable with much larger volumes of 0.8% saline, and is equal to hypertonic saline or hydroxyethyl starch in the ability to restore and sustain BP and improve organ blood flow after resuscitation from hemorrhagic shock.

KW - Cardiac output

KW - Colloids

KW - Hemorrhagic

KW - Hydroxyethyl starch

KW - Intravenous fluid therapy

KW - Liver circulation

KW - Renal circulation

KW - Resuscitation

KW - Saline solution, hypertonic

KW - Shock

UR - http://www.scopus.com/inward/record.url?scp=0025758921&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025758921&partnerID=8YFLogxK

M3 - Article

C2 - 1705491

AN - SCOPUS:0025758921

VL - 19

SP - 364

EP - 372

JO - Critical Care Medicine

JF - Critical Care Medicine

SN - 0090-3493

IS - 3

ER -