McKirnan M D, Williams R L, Limjoco U, Ragland J, Gray C G
Department of Pathology, University of California, San Diego, La Jolla 92093, USA.
Circ Shock. 1994 Dec;44(4):238-46.
To determine the efficacy of low-volume resuscitation in dehydrated subjects, 7.5% hypertonic saline/6% dextran 70 (HSD) and lactated Ringer's (LR) treatments were compared in conscious pigs dehydrated for 48 hr prior to a 37% blood volume hemorrhage. Pigs randomized to treatment were resuscitated with equivalent sodium loads of either HSD (4 ml/kg) or LR (33.3 ml/kg) following the 60-min hemorrhage. Dehydration resulted in a 7-8% body weight loss. Mortality through 180 min of recovery was 1/13 (7.7%) for HSD, 1/11 (9.1%) for LR, and 4/8 (50%) for a group of dehydrated and untreated controls (DC). HSD and LR solutions elicited similar heart rate, cardiac output, arterial pressure, and oxygen transport responses in the recovery period following hemorrhage and resuscitation. HSD was as effective as LR in expanding plasma volume in dehydrated hemorrhaged pigs. Serum chemistries provided no evidence for a sustained systemic toxicity from HSD treatment. These findings support low-volume HSD resuscitation of hemorrhagic shock in moderately dehydrated subjects.
为确定低容量复苏对脱水受试者的疗效，在37%血容量出血前对有意识的猪进行48小时脱水处理，比较了7.5%高渗盐水/6%右旋糖酐70（HSD）和乳酸林格液（LR）的治疗效果。随机接受治疗的猪在60分钟出血后，用等量钠负荷的HSD（4毫升/千克）或LR（33.3毫升/千克）进行复苏。脱水导致体重减轻7 - 8%。恢复180分钟时，HSD组死亡率为1/13（7.7%），LR组为1/11（9.1%），一组脱水且未治疗的对照组（DC）为4/8（50%）。在出血和复苏后的恢复期，HSD和LR溶液引起的心率、心输出量、动脉压和氧运输反应相似。在脱水出血的猪中，HSD在扩充血浆容量方面与LR一样有效。血清化学检测未发现HSD治疗有持续的全身毒性证据。这些发现支持对中度脱水的出血性休克受试者进行低容量HSD复苏。
