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J Korean Soc Emerg Med > Volume 5(1); > Article
OPTIMAL PREOPERATIVE FLUID RESUSCITATION IN NEAR-FATAL UNCONTROLLED HEMORRHAGIC SHOCK IN A RAT MODEL
Seung Ho Kim1, Seok Joon Jang1, Gu Young Jung2, Kyung Ryoung Lee1, Seung Whan Kim1
1Department of Emergency Medicine, Severance Hospital, YUMC
2Department of Emergency Medicine, Mok-Dong Hospital, E-Hwa Women's University
  Published online: July 31, 1994.
ABSTRACT
Recent animal studies have shown that aggressive volume replacement toward more than normotension causes a marked increase in blood loss from the site of vascular injury and pro­ duces significant mortality in animal model of near-fatal( 40 - 50ml/kg bleeding ) uncontrolled hemorrhagic shock(UCHS). The purpose of this study was to establish near-fatal UCHS model in rat and to find the optimal level of preoperative fluid resuscitation in near-fatal UCHS. We could establish UCHS model in rat by transsecting the terminal branch of ileocolic artery and vein. The mean survival time was 54 munutes with no fluid resuscitation. We used this UCHS model to compare the effects of resuscitation to mean arterial pressure of 60 to 80, l00mmHg. Fourty-one mature rats(350 to 500gm) were instrumented and subjected to intraperitoneal bleeding. Ten minutes after transsecting ileocolic vessel, normal saline infusion was begun at 10ml/100g/hr except control group(no fluid resuscitation, n= 12) and continued as needed to maintain the following endpoints : group I ( MAP = 60mm Hg, n = 11 ), group II ( MAP = 80 mmHg, n = 12), and group Ⅲ ( MAP = 100 mmHg, n = 6). When mean arterial pressure was changed to 土5mmHg from each desired mean arterial pressure, normal saline infusion was ceased or maintained. All animals were observed for 120 minutes or until death. No animal sur­vived until 120 minutes. Mean survival time was 48.9minutes, 95.8 minutes, 75.8 minutes, and 75.8 minutes for control group, group I , II , and Ⅲ, respectively. lntraperitoneal hemorrhage volume for four groups was 2.5ml/100g, 6.2ml/100g, 6.7ml/100g, and 9.8ml/100g. In setting of UCHS we conclude that maintenance of the hypotensive state(MAP=60mmHg) with normal saline infusion causes less blood loss and may be preferable before definitive surgical repair of bleeding site.
Key words: Uncontrolled Hemorrhagic Shock, Preoperative Fluid Resuscitation
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