Hypertonic saline resuscitation in a porcine model of severe hemorrhagic shock

The purpose of this study was to investigate the effect of 7.5% hypertonic saline solution (HTS) as the initial solution in resuscitation of a pig in shock. Twenty-two animals were bled 50% of their blood volume over 30 minutes and maintained in shock for 60 minutes. The 14 survivors were divided into two groups. The first group was given 20 mL/kg of lactated Ringer's solution (LR) over a ten-minute period, while the second group was given 10 mL/kg of HTS. Both groups were then given LR at 2 mL/kg/min until the mean arterial pressure reached 80 mm Hg. The HTS group achieved a more rapid rise in mean arterial pressure over the first ten minutes of resuscitation. During this period, the cardiac index increased significantly more in the HTS group when compared with the LR group. All animals in the HTS group developed an adequate urine output. Only two animals in the LR group developed an adequate urine output. Hypertonic saline solution markedly improved survival, and there were significant improvements in hemodynamics. This was accomplished with smaller volumes of resuscitation fluid and may prove useful under conditions where intravascular access is limited.