Journals / Selçuk Tıp Dergisi / 2004 / Cilt: 20 - Sayı: 1

Effects of timing and rate of fluid replacement therapy on renal and liver functions in uncontrolled haemorrhagic shock model

Kontrolsüz hemorajik şok modelinde sıvı replasman tedavisi zamanlaması ve hızının böbrek ve karaciğer fonksiyonları üzerine etkileri

Pages
33–38
DOI
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⚡ TL;DR(Too Long; Didn't Read)

Conclusion: it is concluded that early controlled resuscitation in haemorrhagic shock is effective in preventing the organ damage that can develop during haemorrhagic shock when compared to late or agressive resuscitation

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: To investigate the effects of difFerent volume resuscitation regimens on organ functions in uncontrolled haemorrhagic shock before surgical control of bleeding.
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Key Findings & Data:Material and methods: Total 37 New-Zeland type rabbits divided into fourgroups designatedas S(sham, n=7), C(control, n=10), ECR(early controlled resuscitation, n=10) and EFR(eariy fast resuscitation, n=10).
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Conclusion & Impact:Conclusion: it is concluded that early controlled resuscitation in haemorrhagic shock is effective in preventing the organ damage that can develop during haemorrhagic shock when compared to late or agressive resuscitation
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Sıvı tedavisi · Şok · kanama

Abstract

Objective: To investigate the effects of difFerent volume resuscitation regimens on organ functions in uncontrolled haemorrhagic shock before surgical control of bleeding. Material and methods: Total 37 New-Zeland type rabbits divided into fourgroups designatedas S(sham, n=7), C(control, n=10), ECR(early controlled resuscitation, n=10) and EFR(eariy fast resuscitation, n=10). Rabbits were tef bleeding until mean arterial pressure decreased to 30 mmHg then intracut was taken out to permet free bleeding. S group is sham-operated group. Group C did not receive any volume replacement for an hour after the onset of shock. Volume resuscitation with şalin beginned at rate 2 cc/kg/min to achive MAP 60 mmHg in group ECR while volume resuscitation with şalin beginned at rate 4 cc/kg/min to achive MAP 80 mmHg in group EFR. Bleeding was controlled at first hour in study groups and resuscitation went on foran hour. Liver and renal function teste and haematocrit values were studied basally, first hour and 24th hour respectively. Results: Urea and creatinin levels increased at the first hour in group C. SGOT levels were found to be elevated at 24 hours in group C, ECR, and EFR. Haematocrit values were decreased at 24th hour in group C, ECR, and EFR. Most severe decrease in haematocrit values were observed in group EFR. Conclusion: it is concluded that early controlled resuscitation in haemorrhagic shock is effective in preventing the organ damage that can develop during haemorrhagic shock when compared to late or agressive resuscitation

Özet

Amaç: Kontrolsüz hemorajik şokta, kanamanın cerrahi kontrolünden önce yapılan farklı sıvı resusitasyon rejimlerinin organ fonksiyonları üzerine etkilerinin araştırılması. Gereç ve Yöntem: Toplam 37 adet Yeni-Zelanda tipi tavşan S (sham, n=7), K (kontrol, n=10), EK (erken kontrollü resusitasyon, n=10) ve EH (erken hızlı resusitasyon, n=10) olarak dört gruba ayınldı. Denekler femoral arterden ortalama arteriyel basınç (OAB) 30 mmHg oluncaya kadar kanatıldı ve intraket çekilerek serbest kanamaya bırakıldı. S grubu sham operasyon grubu idi. K grubuna şoktan sonraki bir saatlik sürede sıvı replasmanı yapılmadı. EK grubunda serum fizyolojikle 2 cc/kg/dk hızında, OAB 60 mmHg ve EH grubuna 4 cc/kg/dk hızında, OAB 80 mmHg olması hedeflenerek resusitasyona başlandı. Çalışma gruplarında birinci saatte kanama kontrolü sağlandı ve bir saat daha resusitasyona devam edildi. Bazal, birinci ve 24. saatlerde karaciğer ve böbrek fonksiyon testleri, hematokrit çalışıldı. Bulgular: Birinci saatte üre ve kreatinin değerleri K grubunda artma gösterdi. K, EK, EH gruplarının SGOT değerleri 24. saatte yüksek olarak bulundu. K, EK, EH gruplarında 24. saatte ölçülen hematokrit değerlerinde düşme oldu. Hematokrit değerlerinde en fazla düşme EH grubunda gözlendi. Sonuç: Geç veya agressif resusitasyon yapılan gruplarla karşılaştırıldığında, erken kontrollü sıvı resusitasyonunun hemorajik şokta gelişebilecek organ hasarını önlemede daha etkili olduğu sonucuna varıldı.

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Cite This Article

AK, A., UĞUR, M., GÖKALP, A., KAFALI, M. E., BAYIR, A. A. (2004). Effects of timing and rate of fluid replacement therapy on renal and liver functions in uncontrolled haemorrhagic shock model. Selçuk Tıp Dergisi, Cilt: 20 - Sayı: 1, 33–38. https://ajindex.com/articles/319219

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References (16)

  1. Schlichtig R, Kramer DJ, Pinsky MR. Flow redistribution during progressive hemorrhage is a determinant of critical 02 delivery. J Appl Physiol. 1991
  2. 78 2.Darlington DN, Shinsako J, Dallman MF. Responses of ACTH, epinephrine, norepinephrine, and cardiovascular system to hemorrhage. Am J Physiol. 1986
  3. Tung SH, Wang BC, Brown EB. Intracellular and extracellular acid-base changes in hemorrhagic shock. Respir Physiol 1976
  4. Ploucha JM, Fink GD. Hemodynamics of hemorrhage in the conscious rat and chicken. Am J Physiol. 1986
  5. Carrico JC, Canizaro PC, Shires GT. Fluid resuscitation following injury. Rationale for the use of balanced salt solutions. Crit Care Med. 1976
  6. Moss GS, Lowe RJ, Jilek JM. Colloid or crystalloid in the resuscitation of hemorrhagic shock: A controlled clinictrial. Surgery 1981
  7. 8 7.Comittee on trauma: Advanced Trauma Life Support Course for Physicians. Chicago, American College of Surgeons, 1993. 8.Kaweski SM, Sise MJ, Virgilio RW. The effect of prehospital fluids on survival in trauma patients. J Trauma 1990
  8. 9 9.Bickell WH, Wall MJ, Pepe PE, Martin RR, Ginger W, Ailen MK, et al. Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 1994
  9. 9 10.Gross D, Landau EH, Assalia A, Krausz MM. Is hypertonic şaline resuscitation safe in uncontrolled hemorrhagic shock? J Trauma 1988
  10. 6 11.Bickell WH, Brutting SP, Wade CE. Hemodynamic response to abdominal aortotomy in the anesthetized swine. Circ Shock 1989
  11. 32 12.Gross D, Landau EH, Klin B, Krausz MM. Treatment of uncontrolled hemonrhagic shock with hypertonic saline solution. Surg Gynecol Obstet 1990
  12. 12 13.Bickell WH, Brutting SP, Millnamow GA, O'Benar J, Wade CE. The detrimental effects of intravenous crystalloid after aortotomy in swine. Surgery 1991
  13. 36 14.Ak A, Ustun ME, Ogün CO, Duman A, Bor MA. Effects of nimodipine on tissue lactate and malondialdehyde levels in experimental head trauma. Anaesth intens care 2001
  14. 8 15.Milles G, Koucky CJ, Zacheis HG. Experimental uncontrolled arterial hemorrhage. Surgery 1966
  15. 42 16.Chaudry IH, Clemens MG, Baue AE. Alterations in cell function with ischemia and shock and their correction. Arc Surg 1981
  16. ! 16:1309 17.Malone PC: Might the aphorism "there is no indication in medicine for a pint of blood" lie behind some of the residual morbidity and mortality of surgery? Med hypoth