This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (46)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Michael M. Krausz, MD; Ezekiel H. Landau, MD; Baruch Klin, MD; Diza Gross, PhD

Arch Surg. 1992;127(1):93-96.

Abstract
• Hypertonic saline has been recently recommended for treatment of patients in hemorrhagic shock. Infusion of hypertonic saline at different periods in cases of uncontrolled hemorrhagic shock was studied in rats. The animals were divided into six groups: in group 1 uncontrolled hemorrhagic shock was induced by tail resection and no hypertonic saline was administered; in group 2 hypertonic saline was administered 5 minutes after shock was induced; in group 3 hypertonic saline was administered 15 minutes after shock was induced; in group 4 hypertonic saline was administered 30 minutes after shock was induced; in group 5 hypertonic saline was administered 60 minutes after shock was induced; and in group 6 hypertonic saline was administered 120 minutes after shock was induced. Tail resection in rats in group 1 was followed by a mean±SEM bleeding of 2.7±.03 mL in 5 minutes. Infusion of hypertonic saline after 5 and 15 minutes resulted in additional bleeding of 6.3±1.0 mL and 3.8±0.5 mL, respectively, and a drop in mean arterial pressure to 36±8 mm Hg and 56±9 mm Hg, respectively. Mortality was 80% in group 2 and 53% in group 3. Infusion of hypertonic saline 30 and 60 minutes after shock was induced did not alter bleeding, mean arterial pressure, or survival. Infusion of hypertonic saline within 15 minutes of hemorrhagic shock resulted in increased bleeding, hypotension, and early death. Infusion 30 minutes or later did not alter these variables. This potential danger of early hypertonic saline therapy should be considered in the treatment of patients in trauma.

(Arch Surg. 1992;127:93-96)

Author Affiliations
From the Departments of Surgery B (Drs Krausz and Klin), Urology (Dr Landau), and Anesthesiology (Dr Gross), and the Laboratory for Experimental Surgery (Drs Krausz, Landau, Klin, and Gross), Hadassah University Hospital, Jerusalem, Israel.

Footnotes
Accepted for publication June 5, 1991.

Reprint requests to the Department of Surgery B, Hadassah University Hospital, Kiryat Hadassah, PO Box 1200, Jerusalem, Israel 91120 (Dr Krausz).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The clinical effectiveness of pre-hospital intravenous fluid replacement in trauma patients without head injury: a systematic review
Dretzke et al.
Trauma 2006;8:131-141.
ABSTRACT  

Buccal capnometry to guide management of massive blood loss
Cammarata et al.
J. Appl. Physiol. 2006;100:304-306.
ABSTRACT | FULL TEXT  

Fluid resuscitation in prehospital trauma care: a consensus view
Revell et al.
Emerg. Med. J. 2002;19:494-498.
ABSTRACT | FULL TEXT  

Does animal experimentation inform human healthcare? Observations from a systematic review of international animal experiments on fluid resuscitation
Roberts et al.
BMJ 2002;324:474-476.
FULL TEXT  

Fluid resuscitation in pre-hospital trauma care: a consensus view
Revell et al.
Trauma 2002;4:21-28.
ABSTRACT  

Pre-hospital fluids - when and how much?
Revell and Porter
Trauma 2000;2:179-186.
ABSTRACT  

A Multicenter Trial for Resuscitation of Injured Patients With 7.5% Sodium Chloride: The Effect of Added Dextran 70
Vassar et al.
Arch Surg 1993;128:1003-1013.
ABSTRACT