Fluid Therapy in Hemorrhagic Shock

Continuous cardiac output monitoring via arterial pressure waveform analysis following severe hemorrhagic shock in dogs*

“…Once all catheterization procedures were complete, the dogs were placed in dorsal recumbency and a splenectomy was performed through a midline laparotomy incision. The dogs were splenectomized to limit hemodynamic variability that can be produced by splenic contraction (26,27). The laparotomy incision was closed, and the dogs were returned to right lateral recumbency followed by a 30-min stabilization period.…”

Ethical and Legal Issues in Emergency Research: Barriers to Conducting Prospective Randomized Trials in an Emergency Setting

“…The rapid administration of crystalloid to patients in hemorrhagic shock has long been considered the standard procedure for trauma resuscitation, despite a vacuum of clinical data to support its efficacy. The current practice of large-volume crystalloid administration is based largely on animal studies from the 1950s and 1960s using techniques of controlled hemorrhage, which do not appropriately reflect the physiologic changes actually seen in human trauma patients with ongoing bleeding [52][53]. Using these animal models, it was concluded that the optimal resuscitation strategy was to administer isotonic crystalloid in large volumes (approximately three times whatever amount of blood had been lost) until a normal blood pressure was restored.…”

Determinanten des insensiblen Flüssigkeitsverlustes

“…Als für den Kreislauf potentiell nutzbar sind der interstitielle und der intravasale Flüssigkeitsraum bezeichnet worden, die Kompartimente also, die mit dem Intrazellulärraum im Gleichgewicht stehen. Der Flüssigkeits-verlust in den Dritten Raum wurde als von der Flüssigkeitssubstitution unabhängige, primäre Störgröße angesehen, deren Ausmaß proportional zur Größe des Eingriffes oder Traumas zunimmt [152,154]. Erklärt wurde dieser Verlust überwiegend durch Sequestration in das traumatisierte Gewebe.…”