Comparison of Different Resuscitation Fluids in Volume-Controlled and Uncontrolled Hemorrhage Models Over Time in Swine (Sus scrofa)- Part II
Abstract
Purpose: The purpose of this project was to investigate different resuscitation fluids in volume controlled (CH) and uncontrolled hemorrhagic (UH) shock in swine. Blood products are ideal; however, they can be expensive, have a short shelf life and carry an infection risk. Hydroxocobalamin (HOC) is a small volume, small weight, safe, FDA-approved drug that improves SBP, reduces inflammation and is neuroprotective. HOC could be a useful adjunct to hemorrhagic shock in prehospital, tactical situations and could serve as a bridge for patient stabilization during evacuation to level III facilities during the resuscitation phase. Methods: Controlled (40 percent) and uncontrolled hemorrhagic shock induced in swine. Following hemorrhage, animals were randomized to receive treatment with either whole blood (WB), lactated ringers solution (LR), HOC, PRBC-cold stored platelets, PRBC- room temperature platelets, or Hextend. Animals were monitored for six hours after treatment. Hemodynamic parameters, blood gases and chemistries were collected throughout the duration of the experiment. Data is reported as mean +/- SEM, statistical analysis was performed by ANOVA with a p<0.05. Results: Swine experienced a blood loss of 41 percent +/- 0.02 for CH vs. 33 percent +/- 0.07 for UH. During both UH and CH, HOC administration maintained a higher systolic blood pressure (SBP), cardiac output (CO), SPO2, and vascular resistance (SVR) that was comparable to WB and above LR levels. Blood gas analysis revealed that during CH, lactate, potassium (K+), O2 and CO2 levels were comparable to WB treatment. For UH, CO2 and K+ levels were also comparable to WB; however, CO2 and lactate followed a similar trend to LR. During CH and following HOC administration, Ca2+ levels were elevated at several time points compared to WB and LR treatment.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 30, 2023
- Accession Number
- AD1224617
Entities
People
- Allyson A. Mireles
- Dylan Rodriguez
- Joseph K Maddry
- Maria Castaneda
- R Paredes
Organizations
- 59th Medical Wing