The early systemic and gastrointestinal oxygenation effects of hemmorrhagic shock resuscitation with hypertonic saline and hypertonic saline 6% dextran-70: A comparative study in dogs

dc.contributor.authorCerqueira Braz, José Reinaldo [UNESP]
dc.contributor.authorDo Nascimento Jr., Paulo
dc.contributor.authorPaiva Filho, Odilar
dc.contributor.authorGobbo Braz, Leandro
dc.contributor.authorVane, Luiz Antonio
dc.contributor.authorGalvão Vianna, Pedro Thadeu
dc.contributor.authorRodrigues Jr., Geraldo Rolim
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.date.accessioned2022-04-28T20:07:09Z
dc.date.available2022-04-28T20:07:09Z
dc.date.issued2004-08-01
dc.description.abstractThe smaller volemic state from hypertonic (7.5%) saline (HS) solution administration in hemorrhagic shock can determine lesser systemic oxygen delivery and tissue oxygenation than conventional plasma expanders. In a model of hemorrhagic shock in dogs, we studied the systemic and gastrointestinal oxygenation effects of HS and hyperoncotic (6%) dextran-70 in combination with HS (HSD) solutions in comparison with lactated Ringer's (LR) and (6%) hydroxyethyl starch (HES) solutions. Forty-eight mongrel dogs were anesthetized, mechanically ventilated, and subjected to splenectomy. A gastric air tonometer was placed in the stomach for intramucosal gastric CO2 (PgCO 2) determination and for the calculation of intramucosal pH (pHi): [pHi = pHa - log(PgCO2/PaCO2)]. The dogs were hemorrhaged (42% of blood volume) to hold mean arterial blood pressure at 40-50 mm Hg over 30 min and were then resuscitated with LR (n = 12) in a 3:1 relation to removed blood volume; HS (n = 12), 6 mL/kg; HSD (n = 12), 6 mL/kg; and HES (mean molecular weight, 200 kDa; degree of substitution, 0.5) (n = 12) in a 1:1 relation to the removed blood volume. Hemodynamic, systemic, and gastric oxygenation variables were measured at baseline, after 30 min of hemorrhage, and 5, 60, and 120 min after intravascular fluid resuscitation. After fluid resuscitation, HS showed significantly lower arterial pH and mixed venous PO2 and higher systemic oxygen uptake index and systemic oxygenation extraction than LR and HES (P < 0.05), whereas HSD showed significantly lower arterial pH than LR and HES (P < 0.05). Only HS and HSD did not return arterial pH and pHi to control levels (P < 0.05). In conclusion, all solutions improved systemic and gastrointestinal oxygenation after hemorrhagic shock in dogs. However, the HS solution showed the worst response in comparison to LR and HES solutions in relation to systemic oxygenation, whereas HSD showed intermediate values. HS and HSD solutions did not return regional oxygenation to control values.en
dc.description.affiliationDepartment of Anesthesiology School of Medicine University of São Paulo State, Botucatu, São Paulo
dc.description.affiliationDepartment of Anesthesiology School of Medicine UNESP, PO Box 530, 18618-970 Botucatu, São Paulo
dc.description.affiliationUnespDepartment of Anesthesiology School of Medicine UNESP, PO Box 530, 18618-970 Botucatu, São Paulo
dc.format.extent536-546
dc.identifier.citationAnesthesia and Analgesia, v. 99, n. 2, p. 536-546, 2004.
dc.identifier.issn0003-2999
dc.identifier.scopus2-s2.0-3242812718
dc.identifier.urihttp://hdl.handle.net/11449/224710
dc.language.isoeng
dc.relation.ispartofAnesthesia and Analgesia
dc.sourceScopus
dc.titleThe early systemic and gastrointestinal oxygenation effects of hemmorrhagic shock resuscitation with hypertonic saline and hypertonic saline 6% dextran-70: A comparative study in dogsen
dc.typeArtigo

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