Short-term effects of low-volume resuscitation with hypertonic saline and hydroxyethylstarch in an experimental model of lung contusion and haemorrhagic shock

Prunet, Bertrand; Cordier, Pierre-Yves; Prat, Nicolas; Bourmont, Sophie de; Couret, David; Lambert, Dominique; Michelet, Pierre

doi:10.1016/j.accpm.2016.05.010

Cited by 3 publications

(4 citation statements)

References 25 publications

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“…For example, the short-term resuscitative effect of low-volume fluid resuscitation using hypertonic saline and hydroxyethyl starch (4 mL/kg) was compared with that of normal saline (10 mL/kg) on a pig model with lung contusion. It was demonstrated that the pulmonary edema that usually occurred in normal saline resuscitation was completely avoided when using the low-volume hypertonic saline and hydroxyethyl starch resuscitation 13. The efficiency of small-volume resuscitation was also validated by using other animal models such as rats with pancreatitis-caused microcirculatory disorders or endotoxemia-induced kidney injuries 14,15.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the clinical effect of small-volume resuscitation on uncontrolled hemorrhagic shock in emergency

Zhao

Feng

et al. 2017

TCRM

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ObjectiveThe objective of the present study was to explore the resuscitative effect of small-volume resuscitation on uncontrolled hemorrhagic shock in emergency.MethodsIn this study, the resuscitative effects in 200 trauma patients with uncontrolled hemorrhagic shock in emergency were studied. Half of these patients were infused with hypertonic/hyperoncotic fluid (small-volume resuscitation group, n=100), whereas the rest were infused with Hespan and lactated Ringer’s solution (conventional fluid resuscitation group, n=100). The changes in hemodynamics, coagulation function, blood biochemistry, blood hematology, and the average infusion volume in both the groups were comparatively studied.ResultsIt was found that the hemodynamics were improved in both the groups after resuscitation. Interestingly, compared with trauma patients infused with Hespan and lactated Ringer’s solution, the growth rate, range, and time duration of the mean arterial pressure of the patients in small-volume resuscitation group increased significantly, and the shock index decreased progressively; in the 60th min after the resuscitation, blood index including hemoglobin, hematocrit, red blood cells, white blood cells, and platelet declined, whereas prothrombin time and activated partial thromboplastin time were prolonged in both the groups, but these changes were less obvious in the small-volume group. In addition, the average infusion volume of patients in the small-volume group was less than that of patients in conventional fluid resuscitation group.ConclusionFeatured with small infusion volume and less influence to coagulation function and homeostasis of human body, small-volume resuscitation possesses a significantly higher resuscitative effect. Therefore, trauma patients may have a better chance to maintain the hemodynamic stability and the survival rate, or recovery speed will be increased when traditional aggressive fluid resuscitation is replaced by small-volume resuscitation.

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Section: Introductionmentioning

confidence: 99%

Evaluation of the clinical effect of small-volume resuscitation on uncontrolled hemorrhagic shock in emergency

Zhao

Feng

et al. 2017

TCRM

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“…Experimental studies in pigs in a model of blunt lung injury have confirmed a relationship between increased lung water and administration of crystalloid or artificial colloid solutions, with variable clinical effects ( 28 – 31 ). In these studies, use of crystalloid solutions were associated with increased lung water compared with colloid/crystalloid mixtures.…”

Section: Pulmonary Effects Of Fluid Therapy In Trauma and Lung Contusionsmentioning

confidence: 96%

“…However, rates of up to 30 mL/kg/h for a maximum of 3 h had limited effects on lung function (31). The utility of these experimental studies is questionable due to short follow up times, the cause of injury and controlled nature of the studies (28)(29)(30)(31). However, they point toward a link between increased volumes of crystalloid administration and increased EVLW and potentially pulmonary dysfunction (28)(29)(30)(31).…”

Section: Pulmonary Effects Of Fluid Therapy In Trauma and Lung Contusionsmentioning

confidence: 99%

Fluid Therapy in Pulmonary Disease: How Careful Do We Need to Be?

Adamantos

2021

Front. Vet. Sci.

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Intravenous fluid therapy is a vital and life-saving therapeutic in veterinary medicine. In the absence of heart or lung disease, trauma or sepsis there is limited evidence that fluid therapy will have a detrimental effect on lung function. In healthy dogs there is a reasonable level of experimental evidence that supraphysiologic rates of fluid are required before signs of fluid overload are made evident. In cats, however, this may not be the case. There are higher rates of asymptomatic myocardial disease, but even in the absence of that it seems that some cats may be susceptible to fluid overload. Where systemic inflammation already exists the careful homeostatic and protective mechanisms within the lung are deranged and increases in hydrostatic pressure are more likely to result in fluid movement into the lung tissues. Strategies including restricting the use of intravenous crystalloid fluid administration and using blood products for management of severe hemorrhage are of increasing importance in human trauma and seem to be associated with fewer pulmonary complications, and lower mortality. Managing dogs and cats with sepsis and acute respiratory distress syndrome is already challenging, but ensuring adequate vascular expansion needs to be balanced with avoiding excessive volume administration which may negatively impact pulmonary function. While fluids remain crucial to management of these conditions, there will be an ongoing requirement to balance need without providing excess. The use of point of care ultrasound may provide clinicians with a non-invasive and accessible way to do this.

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“…Importantly, due to ethical reasons, prospective studies can only be realized using in vivo models. Several animal models address trauma questions (Hildebrand et al., ; Rixen et al., ; Robinson et al., ), combining chest trauma and hemorrhagic shock (Prunet et al., ; Seitz et al., ) as well as long‐term outcome (Alam et al., ; Robinson et al., ; Webster et al., ). However, none of these models reflects the intrinsic difficulties in studying the large number of alcohol‐intoxicated patients with respect to the timing of the alcohol use, and the predominant trauma injury mechanism of combined blunt chest trauma (TxT) with hemorrhagic shock.…”

mentioning

confidence: 99%

Acute Alcohol Binge Deteriorates Metabolic and Respiratory Compensation Capability After Blunt Chest Trauma Followed by Hemorrhagic Shock-A New Research Model

Wagner

Franz

Dieteren

et al. 2017

Alcohol Clin Exp Res

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Short-term effects of low-volume resuscitation with hypertonic saline and hydroxyethylstarch in an experimental model of lung contusion and haemorrhagic shock

Cited by 3 publications

References 25 publications

Evaluation of the clinical effect of small-volume resuscitation on uncontrolled hemorrhagic shock in emergency

Evaluation of the clinical effect of small-volume resuscitation on uncontrolled hemorrhagic shock in emergency

Fluid Therapy in Pulmonary Disease: How Careful Do We Need to Be?

Acute Alcohol Binge Deteriorates Metabolic and Respiratory Compensation Capability After Blunt Chest Trauma Followed by Hemorrhagic Shock-A New Research Model

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