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Objective To investigate the effects of delayed fluid resuscitation on hemodynamics and visceral perfusion in dogs with hemorrhagic shock. Methods Fourteen Beagle dogs were prepared for cannulation of carotid artery and jugular vein, and 24 hours later they were subjected to hemorrhagic shock with about 42% of total blood volume exsanguinated. Animals were divided into delayed resuscitation group ( DR group, n = 8) and immediate resuscitation group ( IR group, n = 6) . In the first 24 hours after hemorrhage, dogs in Dr group were given no fluid resuscitation, while those in IR group were immediately given resuscitation with intra-venous glucose-electrolyte solution, of which the volume was three times that of blood loss. In the second 24 hours, all animals had intra-venous fluid resuscitation. The variables of hemodynamics and visceral perfusion were determined before hemorrhage and 2, 4, 8, 24, 48 and 72 hours after hemorrhage under conscious state of dogs. Results After hemorrhage, the mean arterial pressure,cardiac output index, max of left ventricular contractility, blood flow of intestinal mucosa and urinary output greatly decreased and systemic vascular resistance obviously increased in each group compared with those before hemorrhage ( P ＜ 0.05 ) . From 4 hours after hemorrhage, the above measurements of dogs in IR group gradually resumed and reach Oh levels in 72 hours after hemorrhage except systemic vascular resistance index and intestinal blood flow. Whereas those measurements in dogs of DR group kept on worsening, and the levels of mean arterial pressure, cardiac output index, intestinal blood flow and urinary output were significantly lower than those in dogs of IR group ( P ＜ 0. 05 ) . Over 72 hours, five of eight dogs died with anuria in DR, and no animals died in IR group. Conclusion The findings indicate that delayed fluid resuscitation deteriorates hemodynamics, handicapping the restoration of visceral perfusion and increasing mortality in dogs with hemorrhagic shock.
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Objective To investigate the effects of oral glucose-electrolyte solution (GES) on resuscitation of hemorrhagic shock induced by 40% blood volume loss in rats. Methods SD rats were randomly divided into three groups; oral GES without hemorrhagic shock (GES group, n = 16) , hemorrhage shock without fluid resuscitation (HS group, n = 20) and hemorrhagic shock resuscitated with oral GES (HS + GES group, n = 20). About 40% of total blood volume was bled from carotid artery of rats to produce a model of hemorrhagic shock. GES with a volume of three times of blood loss was given three times intragastrically at 0.5, 1 and 6 hours after hemorrhage. Mean arterial pressure (MAP) was measured constantly. Blood flow in liver, kidney, stomach and small intestines, and parameters like hemato-crit, plasma osmotic pressure, alanine aminotransferase (ALT) , creatinine (Cr) and diamine oxidase (DAO) were determined 24 hours after hemorrhage. Survival rates of the rats in three groups were calculated 24 hours after hemorrhage. Results MAPs of HS + GES group were 9. 7% and 10. 9% higher than those of HS group 4 and 24 hours after hemorrhage (P < 0. 05). The blood flow of liver, stomach and small intestines in HS + GES group were 18.6% , 88.4% and 22.0% respectively, higher than those in HS group(P <0.05 or P <0.01) 24 hours after hemorrhage. The hematocrit level of HS + GES group was significantly lower than that of HS group, while the levels of ALT, Cr and DAO in HS + GES group were significantly lower than those in HS group (P <0.01). The survival rate of rats in HS + GES group was 80% , which was significantly higher than 30% in HS group (P <0.01). Conclusions Oral rehydration can significantly improve MAP and tissue perfusion, maintain blood volume and plasma osmotic pressure, alleviate organ damage and hence promote the survival rates of rats with hemorrhagic shock.
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Objective To investigate the effect of oral rehydration on hemedynamies and mierocirculatory perfusion in dogs with fatal hemorrhagic shock.Methods Twenty male Beagle dogs 16-20 months old weighing 8-12 ks were subjected to a loss of 40% of the total blood volume,then divided into 3 groups:no rehydration group (group NR,n=8),oral rehydration group(group OR,n=6)and intravenous rehydration group(group IR,n=6).Group NR received no treatment within 24 h after blood-letting.Group IR and OR were given glucose-electrolyte solution (GES) either by gastric tube or by intravenous infusion 3 times volume of the blood loss immediately after the establishment of the model.Then the lactated Ringer's solution,glucose saline and compound amino acid(2 times volume of the blood loss)were started to be given to supplement the physiological consumption from 24 h after blood-letting in each group.The MAP,cardiac index(CI),systemic vascular resistance (SVR),dp/dtmax,and intestinal mucoflal blood flow (IMBF) were determined before blood-letting(T0,baseline) and 2 h (T1),4 h(T2),8 h(T3),24 h(T4),48 h(T5) and 72 h(T6)after blood-letting.The fatality rate within 72 h after blood-letting and urinary output were calculated.Results The fatality rates were 63%,33%and O in group NR, OR and IR respectively, which showed significant difference between the groups (P < 0.05).Compared with the baseline values at To, MAP, CI and dp/dtmax were significantly decreased at T1-6, in group NR,at T1-5 in group OR and at T1-4 in group IR, and SVR was significantly increased, while IMBF decreased at each time point after blood-letting in the three groups ( P <0.05), but no significant change was found in MAP, CI and dp/dtmax at T6 in group IR and OR (P>0.05). MAP, CI, dp/dtmax , IMBF and urinary output were significantly higher, while SVR was significantly lower in group OR and IR than in group NR ( P < 0.05). MAP, CI,dp/dtmax, IMBF and urinary output were signiflcandy lower, while SVR was significantly higher in group OR than in group IR ( P < 0. 05). Conclusion Oral administration of GES 3 times volume of the blood loss within 24 h after fatal hemorrhagic shock can obviously improve the hemodynamics and microcirculatory perfusion, then improve the survival state and have obvious resuscitation efficacy.