Reversal of postoligemic shock in the cat by hypervenobaric massive fluid therapy

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Abstract
O1igemic hypotension at 40 mm Hg until spontaneous reinfusion of 40% of maximum bled volume (and with a calculated 02 "deficit" not less than 300 cc/kg), followed by reinfusion of all remaining shed blood, resulted in death of seven of eight cats in an average of 6 [plus or minus] 2.5 hr. Plasma osmolality rose during oligemia from 300 to 340 milliosmols/liter. Hypervolemic hypervenobaric therapy was administered in quantity necessary to raise central venous pressure to between 5 and 10 mm of water above control during a 4-hr, period beginning 0.5 hr. after reinfusion. The fluids used were: (1) water, containing normal plasma electrolytes and glucose 1.5% (avg 10.3% body wt); (2) fresh heparinized cat blood (avg 1.8% body wt); and (3) low-molecular weight dextran (mol wt 40,000) (avg 3.4% body wt) in isotonic saline. Survival duration was prolonged by all three fluids, but only 1 significantly reversed shock (7 of 8 cats lived). Those cats which survived had, at the end of the treatment period, larger urine volumes (avg 5.3% body wt) and more complete recovery of blood pH and osmolality. In conclusion, infusion of large volumes of a solution of physiologic electrolytes plus glucose corrected metabolic imbalance and reversed "irreversible" shock.

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