Study On The Effect Of Restrictive Fluid Resuscitation With Multiple Osmotic Saline In Rabbits With Hemorrhagic Shock

Objective: To investigate the effect of hypertonic saline on restrictive fluid resuscitation in rabbits with multiple injuries and hemorrhagic shock.Methods: 1.40 healthy adult rabbits(provided by Laboratory Animal Center of Medical College of Nanchang University)were used to establish hemorrhagic shock model induced by multiple injuries by thoracoabdominal impact injury plus double femoral fractures.2.The rabbits were divided into four groups according to the resuscitation fluid:(a)0.9% sodium chloride resuscitation group(NS);(b)3.0% sodium chloride resuscitation group(3.0%);(c)7.5% sodium chloride resuscitation group(7.5%);(d)6% hydroxyethyl starch resuscitation group(HES),10 rabbits in each group.3.Different fluids were given through femoral vein for restrictive fluid resuscitation according to different groups,and MAP was maintained at about 60 mm Hg.4.Hemodynamic parameters were measured at different time points(0min,30 min,90 min,120 min,240 min)and compare coagulation function,changes in blood lactate and residual alkali,and changes in lung and kidney pathology.5.The volume of infusion required for resuscitation,and the use of vasoactive drugs.Results: 1.There was no significant difference in heart rate and mean arterial pressure between different groups at different time points(P>0.05);2.Compared with the saline group,the changes of blood lactate and alkali residue at different time points in the 3.0% and 7.5% groups were significantly better than those in the saline group and the hydroxyethyl starch group,and the difference was statistically significant(P<0.05);3.The rehydration volume of each group in the 3.0% group and 7.5% group was smaller than that of the saline group.The difference was statistically significant(P<0.05);4.There was no significant difference in blood lactate,alkali excess,coagulation function,and fluid volume at each time point between the 3.0% and 7.5% groups(P>0.05);5.Lung pathological microscopy showed less inflammatory cell infiltration and milder pulmonary interstitial edema in the 3.0% and 7.5% groups.Conclusion: 1.Early application of hypertonic saline fluid resuscitation has the effects of rapid and effective expansion of blood volume,continuous stabilization of hemodynamics,reduction of traumatic coagulopathy and alleviation of secondary systemic inflammation in rabbits with multiple trauma and hemorrhagic shock.2.Early application of hypertonic saline fluid resuscitation can significantly improve the state of multiple trauma and hemorrhagic shock,but there is a risk of hypernatremia and hyperchloremia,especially in the 7.5% sodium chloride group,and the risk is higher with the prolongation of resuscitation time.It is suggested that 3.0% hypertonic fluid should be used in early resuscitation to stop bleeding as soon as possible and obtain blood products for further recovery..