The early liquid resuscitation of uncontrolled hemorrhagic shock in staged abdominal aorta injury / 中华急诊医学杂志

ABSTRACT

Objective To study the early resuscitation with intravenous administration of liquor in uncontrolled hemorrhagic shock model by four-staged abdominal aorta injury in rats in order to settle the controversy over the issue of volume resuscitation.Method Forty Sprague-Dawley rats were canulated with catheters into the left ventricle,femoral artery and femoral vein,respectively.Animals were subjected to vaseular injury of infrarenal pierced with a 25G needle leading to uncontrolled hemorrhagic shock.After aorta injury,the models were processed into 4 stagesearly injured stage,early rescue stage,delayed rescue stage and observation stage.The rescue with rapid infusion of 45 ml/kg lactated Ringer's solution in 15 minutes in the early stage and the followed rescue in the late stage;and(4)sham-rescued.The MAP,CVP,lactic acid and Hct were monitored.The volume of blood loss and the survival time of rats were recorded too.Results After aorta injury,The MAP dropped from 94.3 mmHg to 25.8 mmHg and rised quickly after early resuscitation with rapid infusion of liquor and then again fell soon,and CVP did likewise.Lactic acid was increased and reached 3-4 times of baseline at 4 h in all group except Sham-resuced group.The Hct levels decreased quickly after resuscitation with liquor in early rescue stage and delayed rescue stage.The blood loss in abdomen increased after rapid infusion of lactated Ringer's solution in early rescue stage(blood loss increased from 22.8 ml/kg to 27.7ml/kg,P＜0.05).There Was no significant difference in mortality between those groups.Conclusions Rapid volume resuscitation at early stage of abdominal aorta injured with uncontrolled hemorrhagic shock cannot increase the circulatory blood volume for maintaining stable blood pressure norminimize the elevation of blood lactic acid.On the contrary,resuscitation with rapid administration of liquor at early stage can enhance blood loss and decrease the level of Hct.The survival time and survival rate can't be increased by early rescue with rapid liquor infusion.