Hyperosmotic NaCl and severe hemorrhagic shock

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Abstract
I.v. infusions of highly concentrated NaCl (2400 mosmol/l; infused volume 4 ml/kg, equivalent to 10% of shed blood) given to lightly anesthetized dogs in severe hemorrhagic shock rapidly restore blood pressure and acid base equilibrium toward normality. No appreciable plasma volume expansion occurs for at least 12 h, indicating that fluid shift into the vascular bed plays no essential role in this response. Initial effects were sustained indefinitely: long term survival was 100%, compared to 0% for a similar group of controls treated with saline. Hemodynamic analysis of the effects of hyperosmotic NaCl showed that these infusions substantially increase mean and pulse arterial pressure, cardiac output and mesenteric flow; heart rate was slightly diminished. These effects immediately follow infusions with no tendency to dissipate with time (6 h observation). Hyperosmotic NaCl infusions evidently increase the dynamic efficiency of the circulatory system, enabling it to adequately handle O2 supply and metabolite clearance, despite a critical reduction of blood volume.

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