Hypertonic saline resuscitation in a porcine model of severe hemorrhagic shock
G. G. Stanford, C. R. Patterson, L. Payne and T. C. Fabian
Department of Surgery, University of Tennessee, Memphis 38163.
The purpose of this study was to investigate the effect of 7.5% hypertonic
saline solution (HTS) as the initial solution in resuscitation of a pig in
shock. Twenty-two animals were bled 50% of their blood volume over 30
minutes and maintained in shock for 60 minutes. The 14 survivors were
divided into two groups. The first group was given 20 mL/kg of lactated
Ringer's solution (LR) over a ten-minute period, while the second group was
given 10 mL/kg of HTS. Both groups were then given LR at 2 mL/kg/min until
the mean arterial pressure reached 80 mm Hg. The HTS group achieved a more
rapid rise in mean arterial pressure over the first ten minutes of
resuscitation. During this period, the cardiac index increased
significantly more in the HTS group when compared with the LR group. All
animals in the HTS group developed an adequate urine output. Only two
animals in the LR group developed an adequate urine output. Hypertonic
saline solution markedly improved survival, and there were significant
improvements in hemodynamics. This was accomplished with smaller volumes of
resuscitation fluid and may prove useful under conditions where
intravascular access is limited.
