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    Continuous infusion of small-volume fluid resuscitation in the treatment of combined uncontrolled hemorrhagic shock and head injury
    (2007) Ozturk, Hayrettin; Yagmur, Yusuf; Tas, Askin; Topcu, Soykan; Orak, Murat
    Objective: To determine the effect of continuous limited fluid resuscitation on the hemodynamic response and survival in rats in a model of uncontrolled hemorrhage shock due to Massive Splenic Injury (MSI) and Head Injury (HI). Design: An experimental study. Place and Duration of Study: Dicle University Animal Research Laboratory, Turkey, between January and February 2005. Subjects and Methods: Seventy Sprague-Dawley rats were used in this study. Group 1 rats (n=10) was sham-operated. In group 2 (n=10), only Massive Splenic Injury (MSI) was performed and untreated. In group 3 (n=10), only head injury (HI) was performed and untreated. In group 4 (n=10), HI and MSI were performed and were untreated. In group 5 (n=10), HI and MSI were performed and 15 minutes later treated with 7.5% NaCl. In group 6 (n=10), HI and MSI were performed, and rats were treated with Ringer's Lactate (RL) solution. In group 7 (n=10), HI and MSI were performed, rats were treated with 0.9 % NaCl. In groups 2,4,5,6 and 7 midline incision was reopened and splenectomy was performed at 45 minutes. Results: In group 4 rats, Mean Arterial Pressure (MAP) was decreased from 104 ± 6.1 mmHg to 75 ± 19.5 mmHg at 15 minutes; heart rate decreased from 357 ± 24.9 beats/min to 321 ± 62.1 beats/min and hernatocrit decreased from 46 ± 1.3 % to 43 ± 2.5% (p<0.01). Similar early changes in MAP, heart rate and hematocrit were observed in groups 5, 6, and 7, at 15 minutes. At 45,60 and 120 minutes, in fluid resuscitated rats (group 5,6,7) MAP, heart rate and hematocrit values were measured higher than group 2 and 4 (p<0.01 for all). At 120 min, in group 6, hematocrit was higher than group 4, 5 and 7, in group 6, total blood loss after splenectomy was calculated at 20 ± 2.4% of blood volume and was the best value compared to other fluid resuscitated group 5 and 7 (28% and 27% of blood volume) (p<0.01). Mortality was lower in all fluid resuscitated groups when compared to group 3 and 4 (p<0.05). The median survival time was again higher in fluid resuscitated groups. Conclusion: Continuous infusion of 7.5% NaCl, RL and 0.9 % NaCl following uncontrolled hemorrhagic shock with massive splenic injury and combined head injury resulted in better survival and RL did not increase abdominal bleeding before splenectomy was performed.
  • Küçük Resim
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    Continuous infusion of small-volume fluid resuscitation in the treatment of combined uncontrolled hemorrhagic shock and Head Injury
    (College Physicians & Surgeons Pakistan, 2007) Öztürk, Hayrettin; Yağmur, Yusuf; Taş, Aşkın; Topçu, Soykan; Orak, Murat
    Objective: To determine-the effect of continuous limited fluid resuscitation on the hemodynamic response and survival in rats in a model of uncontrolled hemorrhage shock due to Massive Splenic Injury (MSI) and Head Injury (HI). Design: An experimental study. Place and Duration of Study: Dicle University Animal Research Laboratory, Turkey, between January and February 2005. Subjects and Methods: Seventy Sprague-Dawley rats were used in this study. Group 1 rats (n=10) was sham-operated. In group 2 (n=10), only Massive Splenic Injury (MSI) was performed and untreated. In group 3 (n=10), only head injury (HI) was performed and untreated. In group 4 (n=10), HI and MSI were performed and were untreated. In group 5 (n=10), HI and MSI were performed and 15 minutes later treated with 7.5% NaCl. In group 6 (n=10), HI and MSI were performed, and rats were treated with Ringer's Lactate (RL) solution. In group 7 (n=10), HI and MSI were performed, rats were treated with 0.9% NaCl. In groups 2,4,5,6 and 7 midline incision was reopened and splenectomy was performed at 45 minutes. Results: In group 4 rats, Mean Arterial Pressure (MAP) was decreased from 104 +/- 6.1 mmHg to 75 +/- 19.5 mmHg at 15 minutes; heart rate decreased from 357 +/- 24.9 beats/min to 321 +/- 62.1 beats/min and hematocrit decreased from 46 +/- 1.3% to 43 +/- 2.5% (p<0.01). Similar early changes in MAP, heart rate and hematocrit were observed in groups 5, 6, and 7, at 15 minutes. At 45,60 and 120 minutes, in fluid resuscitated rats (group 5,6,7) MAP, heart rate and hematocrit values were measured higher than group 2 and 4 (p<0.01 for all). At 120 min. in group 6, hematocrit was higher than group 4, 5 and 7, in group 6, total blood loss after splenectomy was calculated at 20 +/- 2.4% of blood volume and was the best value compared to other fluid resuscitated group 5 and 7 (28% and 27% of blood volume) (p<0.01). Mortality was lower in all fluid resuscitated groups when compared to group 3 and 4 (p<0.05). The median survival time was again higher in fluid resuscitated groups. Conclusion: Continuous infusion of 7.5% NaCl, RL and 0.9% NaCl following uncontrolled hemorrhagic shock with massive splenic injury and combined head injury resulted in better survival and RL did not increase abdominal bleeding before splenectomy was performed.
  • Küçük Resim Yok
    Öğe
    Fluid resuscitation in the treatment of uncontrolled hemorrhagic shock
    (Springer Wien, 2008) Yağmur, Y.; Öztürk, Hülya; Orak, Murat; Taş, Aşkın; Güneli, E.
    Background: We evaluated the effect of continuous fluid resuscitation on the hemodynamic response and survival following massive splenic injury (MSI) in rats. Methods: Uncontrolled hemorrhagic shock was produced in 70 rats by sharp transaction. The animals were randomized into 7 groups: group 1 (n = 10), sham-operated; group 2 (n = 10), MSI was untreated and splenectomy was performed after 45 min; group 3 (n = 10), MSI treated after 15 min with 7.5 ml/kg/h of 7.5% NaCl (HTS-7.5) and splenectomy after 45 min; group 4 (n = 10), MSI treated with 35 mL/kg/h Ringers lactate (RL) solution (RL-35) and splenectomy; group 5 (n = 10), MSI treated with 70 mL/kg/h RL (RL-70) and splenectomy, group 6 (n=10), NISI treated with 35mL/kg/h of 0.9% NaCl (NaCl-35) and splenectomy; and group 7 (n=10), MSI treated with 70mL/kg/h of 0.9% NaCl (NaCl-70) and splenectomy. Results: Small and high volume ringer lactate (RL-35, RL-70) infusion increased MAP, pulse rate, and hematocrit level compared to untreated group (p<0.001); however, best response was inquired by RL-35. TBL with RL-35 (22% of blood volume) was less than RL-70 and other groups (p<0.01). High rate of early mortality (33.4% at 30min) with HTS infusion was noticed. TBL was moderately increased in NaCl-70 (32% of blood volume) compared to NaCl-35 (30% of blood volume). Survival time was better with RL-35 and RL-70 at 60 min and 120min, respectively, compared to other groups (p < 0.05). Conclusions: In conclusion, continuous infusion of HTS, RL-70, NaCl-35 and NaCl-70 following massive splenic injury in uncontrolled hemorrhagic shock resulted in a significant increase in intra-abdominal bleeding compared to lower dose RL-35 and greatest survival time was noticed with RL-35 and RL-70 at 60 and 120 min, respectively.