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Vol. 24. Núm. 9.
Páginas 398-404 (diciembre 2000)
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Vol. 24. Núm. 9.
Páginas 398-404 (diciembre 2000)
Acceso a texto completo
Estudio comparativo de la eficacia resucitadora de Ringer lactato, gelatinas y solución salina hipertónica al 2% en un modelo experimental canino de hemorragia aguda
Comparative Study of the Resuscitation Efficacy of Lactated Ringer’s Solution, Gelatins And 2% Hypertonic Saline Solution In An Experimental Canine Model Of Acute Hemorrhage
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9568
J.M. Rabanal*,1, R. Mons**, I. Seco**, R. Calvo*, A. Quesada*, L. García-Castrillo*
* Departamento de Anestesiología y Cuidados Intensivos
** Servicio de Cirugía General y Torácica. Hospital Universitario Marqués de Valdecilla. Santander
Este artículo ha recibido
Información del artículo
Objetivo

Estudiar la eficacia resucitadora de tres tipos de fluidos (Ringer lactato, gelatinas y solución salina hipertónica al 2%) en un modelo canino de hemorragia aguda.

Material y método

Se estudiaron 18 perros anestesiados y monitorizados sometidos a hemorragia gradual. De forma aleatorizada se realizó la resucitación con Ringer lactato (3 ml por ml de sangre extraída) (n = 6), con gelatinas (1 ml por ml de sangre extraída) (n = 6), y con solución salina hipertónica al 2% (1 ml por ml de sangre extraída) (n = 6).

Resultados

Los tres tipos de fluidos fueron eficaces en la resucitación según los parámetros clásicos (presión arterial, gasto cardíaco y presiones de llenado cardíacas). Las gelatinas incrementaron en mayor medida el gasto cardíaco, el transporte del O2 y el consumo de O2. El Ringer lactato incrementó el shunt pulmonar.

Conclusiones

Las gelatinas poseen mayor eficacia resucitadora que el Ringer lactato según los parámetros estudiados. La solución salina hipertónica al 2% no es superior al Ringer lactato o las gelatinas a pesar de incrementar significativamente la natremia.

Palabras clave:
coloides
solución salina hipertónica
shock hemorrágico
fluidoterapia
anestesia experimental
Objective

To study three differents solutions for resuscitation (lactated Ringer, hypertonic saline 2% and urea gelatin) in an experimental dog model for acute bleeding.

Materials and method

Eighteen dogs were anesthesied and monitorized. The dogs were bled down to 35% of their blood volume and randomized to recieve lactated Ringer (3 ml for ml blood lost) (n = 6), hypertonic saline 2% (1 ml for ml blood lost) (n = 6) or gelatines (1 ml for ml blood lost) (n = 6).

Results

All solutions studied were effective in restoring cardiac output, cardiac filling pressure and blood pressure. Pulmonary shunt increased with lactated Ringer.

Conclusions

Gelatines show more resuscitative effecacy than lactated Ringer. Hypertonic saline 2% is not superior to lactated Ringer or gelatines in resuscitation from hemorrhagic shock. Lactated Ringer increased pulmonary shunt.

Key words:
colloids
hypertonic saline
crystalloids
hemorrhagic shock
fluidotherapy
anesthesia experimental
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Bibliografía
[1.]
American College of Surgeons, (1988),
[2.]
E.C. Rackow, J.L. Kalk, I.A. Fein.
Fluid resuscitation in circulatory shock: a comparison of the cardiorespiratory effects of albumina, hetarstarch and saline solutions in patients with hypovolemic and septic shock.
Crit Care Med, 11 (1983), pp. 839-842
[3.]
I.T. Velasco, M. Rocha e Silva.
Hypertonic and hyperoncotic resuscitation from severe hemorrhagic shock in dogs: A comparative study.
Crit Care Med, 17 (1989), pp. 261-264
[4.]
V. Velanovich.
Crystalloid versus colloid fluid resuscitation: a meta-analisis of mortality.
Surgery, 105 (1989), pp. 65-71
[5.]
G. Schierhout, I. Roberts.
Fluid resuscitation with colloid or crystalloid solutions in critically ill patients: a systematic review of randomised controlled trials.
Br Med J, 316 (1998), pp. 961-964
[6.]
S.R. Heckbert, N.B. Vedder, N. Hoffman.
Outcome after hemorrhagic shock in trauma patients.
J Trauma, 45 (1998), pp. 545-549
[7.]
I.T. Velasco, V. Pontieri, M. Rocha e Silva, O.V. Lopes.
Hypertonic NaC and severe hemorrhagic shock.
Am J Physiol, 239 (1980), pp. 664-673
[8.]
J.P. Ducey, D.W. Mozingo, J.M. Lamiell.
A comparison of the cerebral and cardiovascular effects of complete resuscitation with isotonic and hypertonic saline, hetarstach, and whole blood following hemorrhage.
J Trauma, 29 (1989), pp. 1.510-1.511
[9.]
M. Rocha e Silva.
Hypertonic saline resuscitation: a new concept.
Baillièrès Clin Anesthesiol, 11 (1997), pp. 143-161
[10.]
G.C. Kramer, G.I. Elgjo, L.F. Poli de Figueiredo, C.E. Wade.
Hyperosmotic-hyperoncotic solutions.
Baillièrès Clin Anesthesiol, 11 (1997), pp. 143-161
[11.]
M.C. Mazzoni, P. Borgstrom, K.E. Arfors, M. Intaglietta.
Dynamic fluid redistribution in hyperosmotic resuscitation of hypovolemic hemorrhage.
Am J Physiol, 255 (1988), pp. 629-637
[12.]
M.J. Vassar, C.A. Perry, J.W. Holcroft.
Prehospital resuscitation of hypotensive trauma patients with 7,5% NaCl with added dextran: a controlled trial.
J Trauma, 34 (1993), pp. 622-633
[13.]
W.W. Monafo, C. Chuntrasakul, V.H. Ayvazian.
Hypertonic sodium solutions in the treatment of burn shock.
Am J Surg, 126 (1973), pp. 78-82
[14.]
J.B. Salmon, M.G. Mythen.
Pharmacology and physiology of colloids.
Blood Reviews, 7 (1997), pp. 114-120
[15.]
N.D. Kien, P.G. Moore.
Effects of hypertonic saline on regional function and blood flow in canine hearts during acute coronary occlusion.
Shock, 7 (1997), pp. 274-284
[16.]
N.D. Kien, G.C. Kramer.
Cardiac performance following hypertonic saline.
Braz J Med Biol, 22 (1989), pp. 245-248
[17.]
A.W. Goertz, T. Mehl.
Effect of 7,2% hypertonic saline/6% hearstach on left ventricular contractility in anesthesied humans.
Anesthesiology, 82 (1995), pp. 1.389-1.395
[18.]
K. Suzuky, R. Ogino.
Effects of hypertonic saline and dextrano 70 on cardiac function after burns.
Am J Physiol, 268 (1995), pp. 856-864
[19.]
G.J. Hauser, W.C. Shoemaker, I. Turpin.
Hemodynamic and oxygen transport responses to body water shifts produced by colloids and crystalloids in critically ill patients.
Surg Gynecol Obstet, 150 (1980), pp. 811-816
[20.]
W.C. Shoemaker, P.L. Appel, H.B. Kram.
Hemodynamic and oxygen transport monitoring to titrate therapy in septic shock.
New Horizonts, 1 (1993), pp. 145-148
[21.]
G. Smith, F.W. Cheney, P.M. Winter.
The effect of change in cardiac output on intrapulmonary shunting.
Br J Anaesth, 46 (1974), pp. 337-342
[22.]
J.A. Rusell, J.J. Ronco, D.A. Lockhat, A. Belzberg, M. Kiess, P.M. Dodek.
Oxygen delivery and consumption and ventricular preload are greater in survivors than in non survivors of the adult respiratory distress syndrome.
Am Rev Respir Dis, 141 (1991), pp. 659-665
[23.]
A.R. Webb, D. Tighe, R.F. Moss, N. Al-Saady, J.W. Hynd, D.E. Bennet.
Adventages of a narrow-range, medium molecular weight hydroxyethyl starch for volume maintenance in a porcine model of fecal peritonitis.
Crit Care Med, 19 (1991), pp. 409-416
[24.]
J.A. Lowell, C. Schifferdecker, D.F. Driscoll.
Postoperative fluid overload: Not a benign problem.
Crit Care Med, 18 (1990), pp. 728-731
[25.]
E.C. Rackow, J.L. Falk, I.A. Fein.
Fluid resuscitation in circulatory shock: A comparison of the cardiorespiratory effects of albumin, hetastach and saline solutions in patients with hypovolemic and septic shock.
Crit Care Med, 11 (1983), pp. 839-842
[26.]
B.A. Johnson, M.H. Weil.
Redefining ischemia due to circulatory failure as dual defects of oxygen deficits and of carbon dioxide excess.
Crit Care Med, 11 (1995), pp. 1.432-1.438
[27.]
P.F. Moon, G.C. Kramer.
Hypertonic saline-dextran resuscitation from hemorrhagic shock induces transient mixed acidosis.
Crit Care Med, 23 (1995), pp. 323-326
[28.]
J.M. Rabanal, R. Mons, M. Galindo, I. Seco.
Modificaciones de las diferencias arteriovenosas de PCO2 (Da-v PCO2) y pH (Dav pH) en un modelo experimental canino de hemorragia aguda.
Rev Esp Anestesiol Reanim, 46 (1999), pp. 290-296
[29.]
K. Hankeln, C.h. Radel, M. Beez.
Comparison of hydroxyetyl starch and lactated Ringer’s solution on hemodynamics and oxygen transport of critically ill patients in prospective crossover studies.
Crit Care Med, 17 (1989), pp. 133-138
[30.]
M. Rady.
An argument for colloid resuscitation of shock.
Acad Emerg Med, 1 (1994), pp. 572-579
[31.]
J.D. Edwards.
Chloride: the forgotten anion in critically ill.
Int J Intens Care, 7 (2000), pp. 5
Copyright © 2000. Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L.
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