Use of a 7.5% NaCl/6% Dextran 70 solution in the resuscitation of injured patients in the emergency room.

J. W. Holcroft, M. J. Vassar, C. A. Perry, W. L. Gannaway, George Kramer

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Animal studies and preliminary field patient trials suggest that hypertonic saline solutions can achieve resuscitation of hypovolemic shock with extremely small volumes. In the study reported here, we evaluated the effects of a hypertonic 7.5% NaCl/6% Dextran 70 (HSD) solution in the resuscitation of patients in the emergency room. Thirty-two patients were randomized into a prospective, randomized, placebo-controlled, double-blinded trial in which 250 ml of either HSD or, as a control, lactated Ringers (LR) was used as the initial fluid for resuscitation of patients with systolic blood pressures of 80 mmHg or less. The test solution was given intravenously, usually through a saphenous vein cut-down, over a period of 2-5 minutes. Conventional isotonic solutions were then given as necessary with an average of 2500 ml of fluid being given over the first 30 minutes of resuscitation. Survival was not improved, and the trial proved to be of most interest with regard to measurement of physiological quantities, which might have been expected to have been substantially abnormal because, in many cases, the measurements were made shortly after the infusion ran in. Very few abnormalities, however, were in fact detected. With the exception of one patient, the highest sodium concentration was 156 mEq/l, the highest chloride concentration was 126 mEq/1, and the highest osmolality was 401 mOsm/kg, and this value was obtained in a patient in the control LR group. Osmolality correlated far better with blood alcohol levels (Spearman's rank correlation coefficient = 0.81) than with any other variable, including sodium and chloride concentrations. The HSD solution was safe to use.(ABSTRACT TRUNCATED AT 250 WORDS)

Original languageEnglish (US)
Pages (from-to)331-338
Number of pages8
JournalProgress in Clinical and Biological Research
Volume299
StatePublished - 1989
Externally publishedYes

Fingerprint

Dextrans
Resuscitation
Hospital Emergency Service
Osmolar Concentration
Hypertonic Saline Solutions
Blood Pressure
Isotonic Solutions
Saphenous Vein
Nonparametric Statistics
Sodium Chloride
Chlorides
Shock
Sodium
Placebos
Survival

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Use of a 7.5% NaCl/6% Dextran 70 solution in the resuscitation of injured patients in the emergency room. / Holcroft, J. W.; Vassar, M. J.; Perry, C. A.; Gannaway, W. L.; Kramer, George.

In: Progress in Clinical and Biological Research, Vol. 299, 1989, p. 331-338.

Research output: Contribution to journalArticle

@article{861ee7dfb6514192bf2e50d5b60b2f0c,
title = "Use of a 7.5{\%} NaCl/6{\%} Dextran 70 solution in the resuscitation of injured patients in the emergency room.",
abstract = "Animal studies and preliminary field patient trials suggest that hypertonic saline solutions can achieve resuscitation of hypovolemic shock with extremely small volumes. In the study reported here, we evaluated the effects of a hypertonic 7.5{\%} NaCl/6{\%} Dextran 70 (HSD) solution in the resuscitation of patients in the emergency room. Thirty-two patients were randomized into a prospective, randomized, placebo-controlled, double-blinded trial in which 250 ml of either HSD or, as a control, lactated Ringers (LR) was used as the initial fluid for resuscitation of patients with systolic blood pressures of 80 mmHg or less. The test solution was given intravenously, usually through a saphenous vein cut-down, over a period of 2-5 minutes. Conventional isotonic solutions were then given as necessary with an average of 2500 ml of fluid being given over the first 30 minutes of resuscitation. Survival was not improved, and the trial proved to be of most interest with regard to measurement of physiological quantities, which might have been expected to have been substantially abnormal because, in many cases, the measurements were made shortly after the infusion ran in. Very few abnormalities, however, were in fact detected. With the exception of one patient, the highest sodium concentration was 156 mEq/l, the highest chloride concentration was 126 mEq/1, and the highest osmolality was 401 mOsm/kg, and this value was obtained in a patient in the control LR group. Osmolality correlated far better with blood alcohol levels (Spearman's rank correlation coefficient = 0.81) than with any other variable, including sodium and chloride concentrations. The HSD solution was safe to use.(ABSTRACT TRUNCATED AT 250 WORDS)",
author = "Holcroft, {J. W.} and Vassar, {M. J.} and Perry, {C. A.} and Gannaway, {W. L.} and George Kramer",
year = "1989",
language = "English (US)",
volume = "299",
pages = "331--338",
journal = "Progress in Clinical and Biological Research",
issn = "0361-7742",
publisher = "John Wiley and Sons Inc.",

}

TY - JOUR

T1 - Use of a 7.5% NaCl/6% Dextran 70 solution in the resuscitation of injured patients in the emergency room.

AU - Holcroft, J. W.

AU - Vassar, M. J.

AU - Perry, C. A.

AU - Gannaway, W. L.

AU - Kramer, George

PY - 1989

Y1 - 1989

N2 - Animal studies and preliminary field patient trials suggest that hypertonic saline solutions can achieve resuscitation of hypovolemic shock with extremely small volumes. In the study reported here, we evaluated the effects of a hypertonic 7.5% NaCl/6% Dextran 70 (HSD) solution in the resuscitation of patients in the emergency room. Thirty-two patients were randomized into a prospective, randomized, placebo-controlled, double-blinded trial in which 250 ml of either HSD or, as a control, lactated Ringers (LR) was used as the initial fluid for resuscitation of patients with systolic blood pressures of 80 mmHg or less. The test solution was given intravenously, usually through a saphenous vein cut-down, over a period of 2-5 minutes. Conventional isotonic solutions were then given as necessary with an average of 2500 ml of fluid being given over the first 30 minutes of resuscitation. Survival was not improved, and the trial proved to be of most interest with regard to measurement of physiological quantities, which might have been expected to have been substantially abnormal because, in many cases, the measurements were made shortly after the infusion ran in. Very few abnormalities, however, were in fact detected. With the exception of one patient, the highest sodium concentration was 156 mEq/l, the highest chloride concentration was 126 mEq/1, and the highest osmolality was 401 mOsm/kg, and this value was obtained in a patient in the control LR group. Osmolality correlated far better with blood alcohol levels (Spearman's rank correlation coefficient = 0.81) than with any other variable, including sodium and chloride concentrations. The HSD solution was safe to use.(ABSTRACT TRUNCATED AT 250 WORDS)

AB - Animal studies and preliminary field patient trials suggest that hypertonic saline solutions can achieve resuscitation of hypovolemic shock with extremely small volumes. In the study reported here, we evaluated the effects of a hypertonic 7.5% NaCl/6% Dextran 70 (HSD) solution in the resuscitation of patients in the emergency room. Thirty-two patients were randomized into a prospective, randomized, placebo-controlled, double-blinded trial in which 250 ml of either HSD or, as a control, lactated Ringers (LR) was used as the initial fluid for resuscitation of patients with systolic blood pressures of 80 mmHg or less. The test solution was given intravenously, usually through a saphenous vein cut-down, over a period of 2-5 minutes. Conventional isotonic solutions were then given as necessary with an average of 2500 ml of fluid being given over the first 30 minutes of resuscitation. Survival was not improved, and the trial proved to be of most interest with regard to measurement of physiological quantities, which might have been expected to have been substantially abnormal because, in many cases, the measurements were made shortly after the infusion ran in. Very few abnormalities, however, were in fact detected. With the exception of one patient, the highest sodium concentration was 156 mEq/l, the highest chloride concentration was 126 mEq/1, and the highest osmolality was 401 mOsm/kg, and this value was obtained in a patient in the control LR group. Osmolality correlated far better with blood alcohol levels (Spearman's rank correlation coefficient = 0.81) than with any other variable, including sodium and chloride concentrations. The HSD solution was safe to use.(ABSTRACT TRUNCATED AT 250 WORDS)

UR - http://www.scopus.com/inward/record.url?scp=0024572323&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024572323&partnerID=8YFLogxK

M3 - Article

VL - 299

SP - 331

EP - 338

JO - Progress in Clinical and Biological Research

JF - Progress in Clinical and Biological Research

SN - 0361-7742

ER -