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Effects of Differen...
Effects of Different Fluid Regimes and Desmopressin on Uncontrolled Hemorrhage During Hypothermia in the Rat
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- Heinius, Göran (författare)
- Section of Surgery, Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
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- Sondén, Anders (författare)
- Karolinska Institutet
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- Hahn, Robert G (författare)
- Karolinska Institutet,Östergötlands Läns Landsting,Linköpings universitet,Anestesiologi med intensivvård,Hälsouniversitetet,Anestesi- och operationkliniken US
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(creator_code:org_t)
- Mary Ann Liebert, 2012
- 2012
- Engelska.
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Ingår i: Therapeutic Hypothermia and Temperature Management. - : Mary Ann Liebert. - 2153-7658 .- 2153-7933. ; 2:2, s. 53-60
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Abstract
Ämnesord
Stäng
- Resuscitation with large volumes of crystalloids during traumatic hemorrhagic shock might increase the mortality by inducing rebleeding. However, few studies have addressed this problem during hypothermic conditions. Sixty-eight Sprague-Dawley rats were exposed to a standardized femoral artery injury and resuscitated with low (LRe), medium (MRe), or high (HRe) intensity using lactated Ringer's solution after being cooled to 30°C. An additional MRe group was also given desmopressin since this drug might reverse hypothermic-induced impairment of the primary hemostasis. The rats were rewarmed after 90 minutes and observed for 3 hours. The incidence, on-set time, duration, and volume of bleedings and hemodynamic changes were recorded. Rebleedings occurred in 60% of all animals and were more voluminous in the HRe group than in the LRe group (p=0.01). The total rebleeding volume per animal increased with the rate of fluid administration (r=0.50, p=0.01) and the duration of each rebleeding episode was longer in the HRe group than in the LRe group (p<0.001). However, the mortality tended to be higher in the LRe group (LRe=6/15, MRe=1/15, HRe=2/15, p=0.07). Desmopressin did not change the bled volume or the mortality. Overall, the mortality increased if rebleeding occurred (10/35 rebleeders died vs. 1/25 nonrebleeders, p=0.015). Liberal fluid administration increased the rebleeding volume while a trend toward higher mortality was seen with the restrictive fluid program. Desmopressin had no effect on the studied parameters.
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