Riddez L, Stahlberg H, Suneson A, Hjelmqvist H
Department of Surgery, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
Mil Med. 2001 Aug;166(8):695-9.
The effects of hypertonic saline/dextran (HSD) on hemodynamics and on rebleeding were studied during an uncontrolled intra-abdominal hemorrhage combined with a high-energy gunshot wound (GSW) in the hind limb of anesthetized swine. The GSW had instant effects on the central hemodynamics, which were aggravated when the internal hemorrhage was induced. Compared with baseline, cardiac output decreased to about 42%, mean arterial pressure decreased to 52 +/- 4%, and mean flow rates in the splanchnic region, in the upper aorta, and in the kidney decreased to 51 to 15%. The injection of HSD at 10 minutes was followed by a prompt increase in blood flow rates, but rebleeding occurred in five of eight animals, although only two died. In conclusion, GSW induced instant changes in hemodynamics at distance from the injury. When HSD treatment was given in a bolus injection, rebleeding occurred in five of eight animals, although the second hemorrhage became fatal in only one animal.
在麻醉猪后肢的高能枪伤（GSW）合并非控制性腹腔内出血期间，研究了高渗盐水/右旋糖酐（HSD）对血流动力学和再出血的影响。GSW对中心血流动力学有即时影响，当诱导内出血时这种影响会加剧。与基线相比，心输出量降至约42%，平均动脉压降至52±4%，内脏区域、主动脉上部和肾脏的平均流速降至51%至15%。在10分钟时注射HSD后，血流速率迅速增加，但8只动物中有5只发生再出血，尽管只有2只死亡。总之，GSW在远离损伤部位处即时引起血流动力学变化。当以大剂量注射给予HSD治疗时，8只动物中有5只发生再出血，尽管只有1只动物的第二次出血是致命的。
