Prough D S, Johnson J C, Poole G V, Stullken E H, Johnston W E, Royster R
Crit Care Med. 1985 May;13(5):407-11. doi: 10.1097/00003246-198505000-00008.
Hypertonic saline (2400 mOsm/L) has been used successfully for fluid resuscitation of dogs subjected to severe hemorrhagic shock. This study compared the effects of resuscitation with hypertonic saline vs. lactated Ringer's solution on intracranial pressure (ICP) in dogs subjected to 30 min of sustained hypovolemic shock. Hypotension was produced by rapid withdrawal of blood until mean arterial pressure was 50 mm Hg, maintained at that level by withdrawal or infusion of blood over the next 30 min as necessary. Eight animals were resuscitated with hypertonic saline solution and nine with lactated Ringer's solution. Both solutions restored systolic blood pressure and cardiac output to control values. However, diastolic blood pressure and mean arterial pressure did not return to control values. The most prominent difference between the two groups was in ICP measured after resuscitation. ICP was lower in dogs resuscitated with hypertonic saline than in dogs resuscitated with lactated Ringer's solution (p = .029). Hypertonic saline fluid resuscitation may represent a potential alternative when aggravation of intracranial hypertension during resuscitation would place a patient at greater risk.
高渗盐水（2400 mOsm/L）已成功用于严重失血性休克犬的液体复苏。本研究比较了高渗盐水与乳酸林格氏液复苏对经历30分钟持续性低血容量休克犬颅内压（ICP）的影响。通过快速抽血使血压降低，直至平均动脉压达到50 mmHg，并在接下来的30分钟内根据需要通过抽血或输血维持该水平。8只动物用高渗盐溶液复苏，9只用乳酸林格氏液复苏。两种溶液均将收缩压和心输出量恢复至对照值。然而，舒张压和平均动脉压未恢复至对照值。两组之间最显著的差异在于复苏后测量的颅内压。用高渗盐水复苏的犬的颅内压低于用乳酸林格氏液复苏的犬（p = 0.029）。当复苏期间颅内高压加重会使患者面临更大风险时，高渗盐液体复苏可能是一种潜在的替代方法。
