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February 1, 1997Shock

Effect of Hypertonic Saline/Dextran on Post-Stenotic Myocardial Perfusion, Metabolism, and Function During Resuscitation From Hemorrhagic Shock in Anesthetized Pigs

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Why the study?

Does resuscitation with hypertonic saline/dextran improve regional myocardial blood flow, contractile function, and oxygen metabolism compared to normal saline in a porcine model of hemorrhagic shock with critical coronary stenosis?

Population

14 anesthetized, open-chest pigs with a critical left anterior descending coronary artery stenosis subjected…

Comparison

Resuscitation with 7.2% saline/10% dextran 60… vs Resuscitation with normal saline infused over 2…

Design

Preclinical

Authors

MWM. WeltePLPeter LackermeierKlinik für FrauenheilkundeOHO. HäblerLinköping University

Discussion

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Implication

Caution against HSDex resuscitation in shock with coronary stenosis; leaves open targeted perfusion strategies in post-stenotic ischemia.

Structured PICO

Does resuscitation with hypertonic saline/dextran improve regional myocardial blood flow, contractile function, and oxygen metabolism compared to normal saline in a porcine model of hemorrhagic shock with critical coronary stenosis?

P
Population
14 anesthetized, open-chest pigs (25 +/- 3.6 kg) with a critical left anterior descending coronary artery (LAD) stenosis subjected to hemorrhagic shock (mean arterial pressure 45-50 mmHg for 75 min)
I
Intervention
Resuscitation with 7.2% saline/10% dextran 60 (HSDex) (10% of blood loss) infused over 2 min, followed 30 min later by 6% dextran 60 (10% of blood loss)
C
Comparator
Resuscitation with normal saline (NS) (80% of blood loss) infused over 2 min, followed 30 min later by 6% dextran 60 (10% of blood loss)
O
Outcome
Regional myocardial blood flow (MBF), contractile function (segment shortening), and oxygen and lactate metabolismsurrogate

In a porcine model of hemorrhagic shock with critical coronary stenosis, resuscitation with hypertonic saline/dextran or normal saline failed to restore perfusion pressure or reverse ischemia in post-stenotic myocardium.

Cite This Study

Welte et al. (1997) studied this question.

synapsesocial.com/papers/6a90210db71d06dae589d691https://doi.org/10.1097/00024382-199702000-00008
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Myocardial blood flow heterogeneity in shock and small-volume resuscitation in pigs with coronary stenosis1997 · 15 citations
  2. 2Hypertonic saline without or with dextran-70 in the treatment of experimental acute myocardial ischemia and reperfusion1999 · 18 citations
  3. 3Effects of primary resuscitation from shock on distribution of myocardial blood flow2000 · 13 citations
  4. 4Circulatory consequences of reduced endogenous nitric oxide production during small-volume resuscitation2011 · 2 citations
  5. 5The Effect of 7.2% Hypertonic Saline Solution with 6% Dextran 70 on Cardiac Contractility as Observed by an Echocardiography in Normovolemic and Anesthetized Dogs2008 · 5 citations