Schertel E R, Allen D A, Muir W W, Brourman J D, DeHoff W D
Division of Thoracic and Cardiovascular Surgery, College of Medicine, Ohio State University, Columbus 43210, USA.
J Am Vet Med Assoc. 1997 Jan 15;210(2):226-30.
To test the hypothesis that small volumes of hypertonic saline-dextran (HSD) solution can be used to effectively resuscitate dogs in shock induced by gastric dilatation-volvulus (GDV), and, compared with administration of large volumes of lactated Ringer's solution (LRS), can be used to limit the overall volume of fluid needed for resuscitation.
Prospective, clinical study.
15 dogs with GDV-induced shock.
Initially, HSD solution (5 ml/kg of body weight) or LRS (60 to 90 ml/kg) was administered. All dogs then received a maintenance administration (20 ml/kg/h) of LRS. Cardiorespiratory, blood gas, and serum biochemical analyses were performed over a 4-hour period after initiation of treatment.
Systolic arterial and central venous pressures and plasma volume increased more rapidly in dogs in the HSD + LRS group. The cumulative dose of fluids administered to dogs in the HSD + LRS group was significantly less than that administered to dogs in the LRS group. Serum sodium and chloride concentrations and osmolality increased significantly in dogs in the HSD + LRS group, but not in dogs in the LRS group. Ventricular arrhythmias were detected in both groups of dogs, but did not appear to be induced by either form of fluid therapy.
Administration of HSD rapidly restored cardiorespiratory function and induced resuscitation equivalent to administration of large volumes of LRS. Use of HSD solutions to treat dogs in GDV-induced shock may be more efficient than use of isotonic fluids. Administration of HSD solution was not associated with noticeable complications.
验证以下假设:小剂量高渗盐水-右旋糖酐(HSD)溶液可有效复苏因胃扩张-扭转(GDV)导致休克的犬,并且与输注大量乳酸林格氏液(LRS)相比,可用于限制复苏所需的总体液量。
前瞻性临床研究。
15只因GDV导致休克的犬。
最初,给予HSD溶液(5毫升/千克体重)或LRS(60至90毫升/千克)。然后所有犬接受LRS维持输注(20毫升/千克/小时)。在治疗开始后的4小时内进行心肺、血气和血清生化分析。
HSD + LRS组犬的收缩动脉压、中心静脉压和血浆量升高更快。HSD + LRS组犬的累积补液量显著少于LRS组犬。HSD + LRS组犬的血清钠、氯浓度和渗透压显著升高,而LRS组犬未出现此情况。两组犬均检测到室性心律失常,但似乎并非由任何一种液体疗法诱发。
输注HSD可迅速恢复心肺功能并诱导复苏,效果等同于输注大量LRS。使用HSD溶液治疗因GDV导致休克的犬可能比使用等渗液体更有效。输注HSD溶液未出现明显并发症。