ABSTRACT
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]. An experimental study. Dicle University Animal Research Laboratory, Turkey, between January and February 2005. 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. 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. 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