Comparative study on the effects of acetated Ringer's solution, lactated Ringer's solution, Ringer's solution, and 5%...

The abilities of acetated Ringer's solution (AR), lactated Ringer's solution (LR), Ringer's solution (R), and 5% glucose-acetated Ringer's solution (AR-D) to improve canine hemorrhagic shock were investigated. All solutions studied were infused at 1 ml·kg(-1)·min(-1) for 90 min after base excess (BE) reached about -13 mEq·l(-1) by maintaining the mean blood pressure (MBP) at 40 mmHg. MBP, renal blood flow (RBF), vertebral blood flow (VBF), and urinary output significantly increased after the start of infusion of AR, LR, R, and AR-D. The VBF and urinary output were particularly improved with AR-D. The arterial blood level of HCO3 (-) and BE were also increased after the start of infusion of AR, LR, and AR-D but not of R. AR infusion improved BE more effectively than LR. Although AR-D, AR, and LR increased HCO3 (-), the blood pH did not increase in AR-D. The value of plasma acetate increased after the start of infusion of AR and AR-D but not of LR, and R. On the other hand, plasma lactate and pyruvate levels were higher with LR than with AR. The increase in the lactate/pyruvate ratio induced by LR was larger than that by AR. The plasma norepinephrine and epinephrine levels decreased after the start of all infusions. Plasma insulin and glucose levels were markedly increased after the start of AR-D infusion but were not affected by AR, LR, and R. These results indicate that the effectiveness of various infusion solutions such as AR, LR, R, and AR-D during canine hemorrhagic shock varies. AR-D may be useful for increasing both peripheral blood flow and urine output. AR may also be useful for improvement in metabolic acidosis and surgical diabetes induced by hemorrhagic shock.