RESUSCITATION FROM HEMORRHAGIC-SHOCK WITH HYPERTONIC SALINE OR LACTATED RINGERS - EFFECT ON THE PULMONARY AND SYSTEMIC MICROCIRCULATIONS

  • 1 January 1983
    • journal article
    • research article
    • Vol. 10  (2) , 179-188
Abstract
The use of hypertonic salt solution (300 meq Na/l) was compared with Ringer''s lactate as an initial resuscitation fluid for the treatment of hemorrhagic shock. Vascular pressures and cardiac output were monitored as well as microvascular function using chronic lymph fistulae in the lung and soft tissues to reflect transvascular fluid and protein flux. Seven unanesthetized sheep were bled to an aortic pressure of 50 mm Hg (2 h) on 2 occasions 4-5 days apart, and were resuscitated initially with either lactated Ringer''s (LR) or hypertonic saline (HS) to restore left atrial pressure to baseline. This was followed later by the blood return. Cardiac output with HS was significantly increased over that with LR, 8.9 .+-. 1.8, compared with 6.0 .+-. 1.1, in the immediate postresuscitation period with comparable volumes in both groups. Urine output was increased 2-fold with HS Over LR. The initial pulmonary hypertension seen with LR was eliminated with HS. Lymph flow in lung and soft tissue increased to a comparable degree in both groups, the increase being explained by the degree of plasma hypoproteinemia which was present. Apparently, HS increases cardiac output with less net fluid, decreases pulmonary vascular resistance, and does not result in more edema formation when compared with lactated Ringer''s as an initial fluid for treatment of hemorrhagic shock.