Hemodynamic Variables and Tissue Energetics During Resuscitation of Porcine Hemorrhagic Shock with Hextend (Trademark) or Lactated Ringer's Solution
Abstract
There has been recent interest in resuscitation of hemorrhagic shock using new colloid solutions such as Hextend (6% hydroxyethyl starch in balanced salt solution). We examined the effects of resuscitation of porcine hemorrhagic shock with Hextend or lactated Ringer's (LR) solution on hemodynamic parameters and tissue energetics. Anesthetized, instrumented pigs underwent hemorrhagic shock (35% total blood volume, 90 minutes) and were randomized to resuscitation with Hextend 10 cc/kg (n=5), Hextend 20 cc/kg (n=8), or LR 20 cc/kg (n=10) per step in four steps. Endpoints measured included invasive hemodynamics, near infrared (NIR) spectroscopic measures of tissue hemoglobin saturation (StO2) in stomach, liver, and hind limb, and in vivo nuclear magnetic resonance (NMR) measures of tissue phospho-energetics of liver and hind limb. Both groups receiving Hextend resuscitation demonstrated increased cardiac output and oxygen delivery (DO2) compared to animals resuscitated with LR. Phospho-energetics (hind limb phospho-creatine) improved more rapidly in Hextend groups compared to animals receiving LR. There were no significant differences between groups with respect to StO2 in hind limb or stomach. Hextend resuscitation resulted in improved hemodynamics and tissue energetics secondary to improved filling pressures in this porcine model of controlled hemorrhagic shock. Equivalent hemodynamic improvement was achieved with Hextend at 1/3 the volume of LR. This product may have significant application in austere environments where the volume of resuscitative fluid is limited due to mission constraints.
Document Details
- Document Type
- Technical Report
- Publication Date
- Sep 01, 2004
- Accession Number
- ADA444876
Entities
People
- Bruce E. Hammer
- Greg J. Beilman
- Jodie H. Taylor
- Kristine E. Mulier
- Mark J. Conroy
Organizations
- University of Minnesota