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Dose response characteristics of hypertonic saline dextran solutions
L Halvorsen1, R A Gunther, M A Dubick
1Department of Surgery, University of California, Davis.
The Journal of Trauma
|June 1, 1991
Summary
Researchers found that a 7.5% saline and 12% dextran 70 solution is the most effective hypertonic saline-dextran (HSD) for resuscitation in shock models. This HSD formulation improved cardiac output and blood pressure in sheep.
Area of Science:
- Emergency Medicine
- Cardiovascular Physiology
- Resuscitation Science
Background:
- Prehospital resuscitation requires effective fluid therapies.
- Hypertonic saline-dextran (HSD) solutions are being investigated for their efficacy.
Purpose of the Study:
- To determine the optimal composition of HSD for prehospital resuscitation.
- To evaluate the dose-response relationship of varying saline and dextran concentrations.
Main Methods:
- 33 sheep underwent a controlled hemorrhage model (50 mm Hg for 2 hours).
- Animals were resuscitated with 4 ml/kg HSD via a 2-minute bolus.
- Experiments systematically varied dextran 70 and sodium chloride (NaCl) concentrations.
Main Results:
- Cardiac output increased with higher dextran 70 concentrations (up to 12%).
- Mean arterial blood pressure improved with 6% and 12% dextran 70 solutions.
- Optimal NaCl concentration for resuscitation plateaued at 7.5%, with no added benefit from 10%.
Conclusions:
- A 7.5% NaCl/12% dextran 70 solution appears most effective for resuscitation in this prehospital shock model.
- This optimized HSD formulation warrants further clinical investigation.