The effect of intraabdominal pressure and saline infusion on abdominal aortic hemorrhage

Blood loss, survival, and hemodynamics were monitored for 1 hour or until death in 30 anesthetized pigs with a 0.5 cm abdominal aortic laceration. Eight animals (Group I) had no treatment; 7 animals (Group IA) had saline infusion at a maximum rate of 200 mls/min to maintain carotid artery pressure (CP); 8 animals (Group II) had intraabdominal pressure increased to 60 torr by pneumatic antishock garment (PASG) inflation; and 7 animals (Group IIA) had PASG inflation with saline infusion to maintain CP. Groups I and IA survived 9.5 +/- 4.2 minutes and 28.0 +/- 5.5 minutes, respectively (p less than 0.05). Groups II and IIA survived the 1 hour. Saline infusion (5400 +/- 120 mls in Group IA and 535 +/- 180 mls in Group IIA, p less than 0.05) increased blood loss without PASG inflation (1289 +/- 49 mls in Group I vs. 4840 +/- 1350 mls in Group IA, p less than 0.05) as well as with PASG inflation (438 +/- 64 mls in Group II vs. 1235 +/- 68 mls in Group IIA, p less than 0.05). CP could not be maintained in spite of saline infusion in Group IA but in Group IIA CP was maintained with saline infusion. In an otherwise fatal abdominal aortic laceration, increasing intraabdominal pressure improves survival and decreases hemorrhage. While saline infusion may prolong survival it increases hemorrhage both in the presence and absence of increased intraabdominal pressure.