European Surgery

, 40:130 | Cite as

Fluid resuscitation in the treatment of uncontrolled hemorrhagic shock

Original Scientific Paper

Summary

BACKGROUND: We evaluated the effect of continuous fluid resuscitation on the hemodynamic response and survival following massive splenic injury (MSI) in rats. METHODS: Uncontrolled hemorrhagic shock was produced in 70 rats by sharp transaction. The animals were randomized into 7 groups: group 1 (n = 10), sham-operated; group 2 (n = 10), MSI was untreated and splenectomy was performed after 45 min; group 3 (n = 10), MSI treated after 15 min with 7.5 ml/kg/h of 7.5% NaCl (HTS-7.5) and splenectomy after 45 min; group 4 (n = 10), MSI treated with 35 mL/kg/h Ringers lactate (RL) solution (RL-35) and splenectomy; group 5 (n = 10), MSI treated with 70 mL/kg/h RL (RL-70) and splenectomy; group 6 (n = 10), MSI treated with 35 mL/kg/h of 0.9% NaCl (NaCl-35) and splenectomy; and group 7 (n = 10), MSI treated with 70 mL/kg/h of 0.9% NaCl (NaCl-70) and splenectomy. RESULTS: Small and high volume ringer lactate (RL-35, RL-70) infusion increased MAP, pulse rate, and hematocrit level compared to untreated group (p < 0.001); however, best response was inquired by RL-35. TBL with RL-35 (22% of blood volume) was less than RL-70 and other groups (p < 0.01). High rate of early mortality (33.4% at 30 min) with HTS infusion was noticed. TBL was moderately increased in NaCl-70 (32% of blood volume) compared to NaCl-35 (30% of blood volume). Survival time was better with RL-35 and RL-70 at 60 min and 120 min, respectively, compared to other groups (p < 0.05). CONCLUSIONS: In conclusion, continuous infusion of HTS, RL-70, NaCl-35 and NaCl-70 following massive splenic injury in uncontrolled hemorrhagic shock resulted in a significant increase in intra-abdominal bleeding compared to lower dose RL-35 and greatest survival time was noticed with RL-35 and RL-70 at 60 and 120 min, respectively.

Keywords

Uncontrolled hemorrhagic shock Massive splenic injury in rats 

Volumenersatztherapie bei hämorrhagischem Schock

Zusammenfassung

GRUNDLAGEN: Der Effekt von Volumenersatz auf Hämodynamik und Überleben nach Milzverletzung in Ratten wurde untersucht. METHODIK: Hämorrhagischer Schock wurde bei 70 Ratten durch Milzverletzung induziert. Volumenersatztherapie: Gruppe 1 (n = 10) sham-operiert; Gruppe 2 (n = 10) MMV war nicht therapiert und nach 45 Minuten die Splenektomie durchgeführt; Gruppe 3 (n = 10) MMV, nach 45 Minuten mit 7,5 ml/kg/h NaCl (HTS-7,5) therapiert und nach 45 Minuten die Splenektomie durchgeführt; Gruppe 4 (n = 10) MMV, mit 35 ml/kg/h Ringer Lactat (RL-35) Lösung therapiert und die Splenektomie durchgeführt; Gruppe 5 (n = 10) MMV, mit 70 ml/kg/h Ringer Lactat (RL-70) Lösung therapiert und die Splenektomie durchgeführt; Gruppe 6 (n = 10), MMV, mit 35 ml/kg/h von 0,9 % NaCl (NaCl-35) und die Splenektomie durchgeführt; und Gruppe 7 (n = 10) MMV, mit 70 ml/kg/h von 0,9 % NaCl (NaCl-70) und die Splenektomie durchgeführt. ERGEBNISSE: Niedrig- und Hoch-Volumen Ringer Lactat (RL-35, RL-70) Infusion steigert MMV, die Pulsfrequenz und den Hämatokrit-Spiegel vs. zur unbehandelten Gruppe (p < 0,001), jedoch die beste Wirkung brachte RL-35. TBL mit RL-35 (22 % des Blut-Volumens) war geringer vs. RL-70 und den anderen Gruppen (p < 0,01). Die Überlebenszeit war am besten mit RL-35 und RL-70 für 60 min und 120 min (p < 0,05). SCHLUSSFOLGERUNGEN: Kontinuierliche Infusion von RL-35 und RL-70 für 60 und 120 min erbrachte die besten Ergebnisse in diesem Ratten-Modell der Milzverletzung.

Schlüsselwörter

Hämorrhagischer Schock Milzverletzung 

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Y. Yagmur
    • 1
  • H. Ozturk
    • 2
  • M. Orak
    • 3
  • A. Tas
    • 4
  • E. Guneli
    • 5
  1. 1.Department of General SurgeryMedical School, Dicle UniversityDiyarbakirTurkey
  2. 2.Department of Pediatric Surgery, Izzet Baysal Medical FacultyAbant Izzet Baysal UniversityBoluTurkey
  3. 3.Department of EmergencyMedical School, Dicle UniversityDiyarbakirTurkey
  4. 4.Department of PharmacologyMedical School, Dicle UniversityDiyarbakirTurkey
  5. 5.Experimental Animal Research LaboratoryMedical School, Dokuz Eylul UniversityIzmırTurkey

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