The effect of heat load and dehydration on hypertonic saline solution treatment of uncontrolled hemorrhagic shock.

Hypertonic saline solution treatment of uncontrolled hemorrhagic shock (UCHS) leads to increased bleeding from injured vessels, fall in arterial blood pressure, and increased mortality. The effect of dehydration induced by either water deprivation or heating on this response was studied in rats. The animals were divided into four groups: group 1 (n = 32), normal rats; group 2 (n = 30), water deprivation for 12 hours; group 3 (n = 30), heating at 37 degrees C for 5 hours; and group 4 (n = 30), heating as in group 3 and water deprivation as in group 2. UCHS was induced in all rats by 20% resection of the animals' tail. The rats were then divided into four treatment subgroups: group a was untreated, group b was treated after 15 minutes with 5 mL/kg NaCl 7.5% hypertonic saline (HTS), group c was treated after 15 minutes with 41.5 mL/kg NaCl 0.9% large volume normal saline (LNS) and group d was treated after 15 minutes with HTS + LNS. Tail resection in group 1a resulted in bleeding of 4.9 +/- 0.3 mL, and fall in mean arterial pressure (MAP) to 50 +/- 3 mm Hg (p < 0.001). Blood loss and fall in hematocrit in groups 2, 3, and 4 was significantly lower than in group 1. The fall in MAP and pulse rate was similar in all four groups.(ABSTRACT TRUNCATED AT 250 WORDS)

[1]  C. Wade,et al.  Effect of dehydration on cardiovascular responses and electrolytes after hypertonic saline/dextran treatment for moderate hemorrhage. , 1992, Annals of emergency medicine.

[2]  F Sargent,et al.  Voluntary dehydration in man. , 1965, Journal of applied physiology.

[3]  G. Kramer,et al.  Infusion of very hypertonic saline to bled rats: membrane potentials and fluid shifts. , 1985, The Journal of surgical research.

[4]  D. Birolini,et al.  The role of lung innervation in the hemodynamic response to hypertonic sodium chloride solutions in hemorrhagic shock. , 1985, Surgery.

[5]  E H Landau,et al.  Is hypertonic saline resuscitation safe in 'uncontrolled' hemorrhagic shock? , 1988, The Journal of trauma.

[6]  P. Maningas Resuscitation with 7.5% NaCl in 6% dextran-70 during hemorrhagic shock in swine: effects on organ blood flow. , 1987, Critical care medicine.

[7]  S. Shibolet,et al.  Heat stroke: a review. , 1976, Aviation, space, and environmental medicine.

[8]  E. Sohar,et al.  Heatstroke: its clinical picture and mechanism in 36 cases. , 1967, The Quarterly journal of medicine.

[9]  P. Pepe,et al.  Prehospital hypertonic saline/dextran infusion for post-traumatic hypotension. The U.S.A. Multicenter Trial. , 1991, Annals of surgery.

[10]  M. Krausz,et al.  Quantitative measurement of bleeding following hypertonic saline therapy in 'uncontrolled' hemorrhagic shock. , 1989, The Journal of trauma.

[11]  E H Landau,et al.  Hypertonic saline infusion in hemorrhagic shock treated by military antishock trousers (MAST) in awake sheep , 1993, Critical care medicine.

[12]  M. Vassar,et al.  7.5% sodium chloride/dextran for resuscitation of trauma patients undergoing helicopter transport. , 1991, Archives of surgery.

[13]  M. Vassar,et al.  Prehospital resuscitation of hypotensive trauma patients with 7.5% NaCl versus 7.5% NaCl with added dextran: a controlled trial. , 1992, The Journal of trauma.

[14]  M. B. Wolf Plasma volume dynamics after hypertonic fluid infusions in nephrectomized dogs. , 1971, The American journal of physiology.

[15]  M. Krausz,et al.  Hypertonic saline treatment of uncontrolled hemorrhagic shock at different periods from bleeding. , 1992, Archives of surgery.

[16]  R. Francesconi,et al.  Simultaneous determination of fluid shifts during thermal stress in a small-animal model. , 1986, Journal of applied physiology.

[17]  A. Borut,et al.  Effect of acute dehydration on body fluid compartments in three rodent species, Rattus norvegicus, Acomys cahirinus and Meriones crassus , 1970 .

[18]  J. Mitchell,et al.  Acute effects of increased serum osmolality on left ventricular performance. , 1969, The American journal of physiology.

[19]  M. H. Bloomberg A method for the control of postoperative pain in hallux valgus operations , 1940 .

[20]  G. Kramer,et al.  A comparison of several hypertonic solutions for resuscitation of bled sheep. , 1985, The Journal of surgical research.