The Effect of Hypertonic Salt Solution on Oxygen Delivery and Tissue Oxygen Consumption in Resuscitation from Hemorrhagic Shock

Kim, Jae Hwang; Chung, Yun Woong; Park, Dong Ill; Shim, Min Chul; Kwun, Koing Bo

J Korean Soc Emerg Med > Volume 1(1); 1990 > Article

Journal of The Korean Society of Emergency Medicine 1990;1(1): 77-83.

Jae Hwang Kim, Yun Woong Chung, Dong Ill Park, Min Chul Shim, Koing Bo Kwun

ABSTRACT

Recently it has been reported and confirmed that hypertonic salt sloution is more effective than sostonic salt soultion in resuscitation from hemorrhagic shock. However the direct correlation of improved hemodynamics with oxygen consumption and restored ceUular function has not been clearly evaluated. Authors conducted an experiment of evaluate the changes of cellular function after hypertonic resuscitation by means of observing the tissue oxygen consumption, blood PH and oxygen delivery. 15 dogs were divided into 3 groups with 5 dogs each, and bled to shock(MAP: mean arterial presssure: 70 mmHg). Normal saline(Group I: 300mOsm), 3% Nacl(Group II: 1000mOsm) and 3% Nacl 5% Dextan40(Group III: 1100mOsm) solution were used for resuscitation in each group. Changes of hemodynamics and blood gas were observed. Hemodynamic improvement was dramatic in hypertonic groups as shown on our previous report(l). Arterial oxygen delivery was increased in all groups after resuscitation and no significant differences between groups were noted. Mixed venous oxygen delivery increased in all groups at immediate resuscitation, but it increased significantly in hypertonic group by 90 minutes. Tissue oxygen consumption decreased in hypertonic group more than isotonic group immediately after resuscitation (G I 126.8ml O"/ml, GII 76.5ml O"/ml , GIII 75.4ml O"/ml). But after 90 minutes, it decreased to 43.4ml O"/min in G I, and increased upto 99.3ml O"/min, 84.8 ml O"/min in GII GUI, each. In condusion, tissue O" consuption and PH were not improved.immediately after hypertonic resuscitation in spite of dramatic impmvement 'of hemodynamics, but they gradually improved to normal range. The serum PH change was correlated with the tissue O" consumption. In isotonic Group, the sustained increase in MAP could not improve the tissue O" consumption and PH effectively.