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Resuscitation with hydroxyethyl starch 130/0.4 versus lactated Ringer on hemorrhage following a liver trauma in swine
Author(s) -
Zaar Morten,
Lauritzen Brian,
Secher Niels H.,
Krantz Torben,
Johansson Pär I.
Publication year - 2008
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.22.1_supplement.1227.1
Subject(s) - hydroxyethyl starch , resuscitation , medicine , anesthesia , ringer's solution , hetastarch , hemostasis , liver injury , surgery
Background : The effect of resuscitation fluids on hemorrhage remains disputed. This study evaluated the effect of resuscitation with hydroxyethyl starch 130/0.4 versus lactated Ringer on hemorrhage in a pig liver trauma model. Methods : A grade III crush and avulsion liver injury was inflicted on the left lateral lobe and, to simulate a pre‐hospital setting, resuscitation began after 7 min: phase 1, 0.7 mL kg −1 min −1 for 10 min; phase 2, 1.65 mL kg −1 min −1 for 20 min; and phase 3, according to the blood loss. Initial resuscitation was with hydroxyethyl starch 130/0.4 or lactated Ringer while in phase 3 it was with hydroxyethyl starch 130/0.4, and lactated Ringer was also evaluated for a grade IV laceration liver injury. Results : With a grade III liver injury, initial resuscitation with hydroxyethyl starch 130/0.4 (n=5) caused progressive bleeding and exsanguination after ~75 min, while lactated Ringer (n=5) elicited a slow bleeding that ceased after ~45 min. With a grade IV injury (n=5), initial resuscitation with lactated Ringer caused exsanguination after ~75 min. Conclusion : For a mild liver injury, initial resuscitation with hydroxyethyl starch 130/0.4 appeared to provoke uncontrolled hemorrhage, while hemostasis was achieved in animals resuscitated with lactated Ringer. In contrast, hemostasis was not achieved in animals with a severe liver trauma and resuscitated with lactated Ringer.