Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Effectiveness of different resuscitation methods for severe uncontrolled hemorrhagic shock in a dog model

Shan Jiang¹ , Shaoming He², Yang Sun¹

¹Department of Anesthesiology, Nanjing Chest Hospital Affiliated to Southeast University School of Medicine; ²Department of Anesthesiology, 454th Hospital of Chinese People's Liberation Army, Nanjing, China.

For correspondence:- Shan Jiang Email: yd548i@163.com

Accepted: 27 October 2019 Published: 30 November 2019

Citation: Jiang S, He S, Sun Y. Effectiveness of different resuscitation methods for severe uncontrolled hemorrhagic shock in a dog model. Trop J Pharm Res 2019; 18(11):2391-2396 doi: 10.4314/tjpr.v18i11.23

© 2019 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To compare the effects of pituitrin resuscitation, hypertonic saline resuscitation and limited fluid resuscitation on a novel dog model of severe uncontrolled hemorrhagic shock (UCHS).

Methods: Severe UCHS was produced in healthy Chinese dogs (n = 24) using a standard method. The hemorrhaged dogs were randomly divided into three groups of 8 dogs each: vasopressin group (group A), hypertonic saline group (group B), and low-volume fluid resuscitation group (group C). Group A received pituitrin at an initial dose of 0.1U/kg intravenously, which was thereafter reduced to 0.04 U/kg/min. Group B dogs received 7.5 % hypertonic saline (6 mL/kg), while dogs in group C were treated with 6 % hydroxyethyl starch (HES) 200/0.5. Mean arterial pressure (MAP) of the dogs was maintained between 50 and 55 mmHg, and after 1 h, full-volume resuscitation was administered. Hemodynamic parameters, blood gas, levels of inflammatory factors and blood loss were assessed at different time points.

Results: Compared with group A, hemodynamic parameters in group B were higher; hematocrit of group B was lower; IL-10 of groups B and C were reduced, but TNF-α, TNF-α/IL-10 and ACTH were elevated (p < 0.05). Relative to group C, base deficits in groups A and B were low. During uncontrolled hemorrhage phase, blood loss in group B was higher than that in other groups (p < 0.05).

Conclusion: The results obtained in this study suggest that pituitrin resuscitation produces relatively optimal effect through effective maintenance of coronary perfusion pressure (CPP) and reduction of inflammatory responses.

Keywords: Uncontrolled hemorrhagic shock, Pituitrin resuscitation, Limited fluid resuscitation, Hypertonic saline resuscitation, Heart rate