| Battlefield statistics show that 50% of deaths are due to acute hemorrhage. The conventional fluid therapy of hemorrhagic shock is limited by difficulty in delivering large volumes of fluid in the field. The concept of small-volume resuscitation, the rapid infusion of a small volume of hypertonic saline solution for the initial therapy of severe hemorrhagic shock was advocated more than a decade ago. Numerous publications have established that the administration of hypertonic saline solutions during hemorrhagic shock allowed rapid shift of fluid from intracellular to extracellular space, improved peripheral perfusion and stabilized hemodynamic variables. It can restore arterial blood pressure, cardiac index and oxygen delivery as well as organ perfusion to pre-shock values in a small volume and during a short time period.The purpose of this study was to compare the effects of hypertonic saline solution resuscitation in a canine-modified wigger's hemorrhagic shock model when this solution was used. The effects of hypertonic saline solution on ICAM-1 , PMN, CD11b and Fas were observed to explore the mechanism of the protection.The results showed that:1. After the dogs were presented with the hemorrhagic shock, there were significant changes in their hemodynamic parameters. All animals had great fall in Cardiac output(CO), Cardiac index(CI), Mean arterial pressure(MAP), Left ventricular stroke work index(LVSWI). After resuscitation, the values of CO, CI, MAP, LVSWI, in HSH group were rapidly restored to or even higher than baseline values . Although the values of CO, CI, LVSWI in NS group have made some increase just after theresuscitation, they were markedly lower than those of HSH group in the velocity of increase and the maintenance time (P<0.01,). The values of MAP, LVSWI in NS group were markedly higher shock levels after resuscitation, but they were always lower than baseline levels. There were significant differences between two groups(P<0.01 or 0.05).2. During the hemorrhagic shock phase, the levels of Oxygen consumption, Oxygen delivery in both groups all significantly decreased while Oxygen extraction ratio markedly increased, higher than baseline values (P<0.01). After the resuscitation, the values of VO2, O2ER in HSH group have been restored to baseline values while the values of DO2 also improved ,higher than shock level(P<0.05); The values of DO2,VO2 in NS group had ever increased to higher than shock level ,but soon decreased to lower than baseline values while O2ER were still higher than baseline level(P<0.05). By 3 hours, DO2, O2ER in HSH group were restored to shock level again (P>0.05).3. During the hemorrhagic shock phase, lactic acid and BD of two groups was all markedly higher than baseline values (P<0.01). At 30 minutes Postresuscitation, the values of lactic acid and BD in HSH group decreased rapidly (P>0.05) while the values in NS group were still lower than baseline values(P<0.05). By 3 hours, the values of lactic acid and BD were higher than baseline values again. There were no significant differences at this phase between two groups (P>0.05).4. The values of ICAM-1 concentration during hemorrhagic shock were significantly higher than those in control(P<0.01), but the values of ICAM-1 concentration in HSH group were significantly lower than those in NS group(P<0.05). Meanwhile, the levels of PMN CDllb expression during hemorrhagic shock were significantly higher than those in control(P<0.01), but the levels of PMN CDllb expression in HSH group were significantly lower than those in NS group(P<0.05).5. The levels of PMN Fas expression during hemorrhagic shock were significantly lower than those in control(P<0.01), but the levels of PMN Fas expression in HSH group were significantly higher than those in NS group(P<0.05).Conclusion:1. After the animals were resuscitated with initial small-volume hypertonic saline, the hypertonic saline can improve the state of ani...
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