Crystalloid is as effective as blood in the resuscitation of hemorrhagic shock.
TLDR
The results suggest that there should perhaps be a higher threshold for blood transfusion in the management of severe trauma-hemorrhagic shock than is currently practiced.Abstract:
Recently there has been increasing concern over transfusion-related diseases, especially acquired immune deficiency syndrome (AIDS). The authors therefore investigated the efficacy of lactated Ringer's solution (LRS) alone as compared with blood plus LRS resuscitation on body weight change and mortality rate after severe trauma-hemorrhagic shock. Rats, 250 to 310 g (n = 85), had a midline laparotomy performed (i.e., trauma induced), the incision was closed, and a carotid artery, jugular vein, and femoral artery were cannulated. The unrestrained, nonheparinized rats were allowed to recover from anesthesia and were bled within 10 minutes to a mean arterial pressure (MAP) of 40 mmHg. This MAP was maintained by removing more blood until the animal was unable to compensate (maximal bleedout; MB). The MAP was further maintained at 40 mmHg by returning fluid (LRS) until 50% of the MB volume (MBV) was returned. The rats were then resuscitated: group 1 with LRS 4 times the MBV; group 2 with 5 x LRS; group 3 with the shed blood returned + 2 x LRS. There was no difference between the groups in the initial weights, MAP, or hematocrit (Hct), percentage of blood volume removed, time to MB, or time to end of hemorrhage. The final Hct and MAP were higher in group 3 (p less than 10(-6)) than in either of the other groups. Body weight gain was greater in group 2 compared with either of the other groups (p less than 0.05) on day 1 after hemorrhage because of edema, but no differences were seen on subsequent days. There were no differences in the survival of animals in the different groups. These results suggest that there should perhaps be a higher threshold for blood transfusion in the management of severe trauma-hemorrhagic shock than is currently practiced.read more
Citations
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Detrimental effects of perioperative blood transfusion
TL;DR: It was also anticipated that the use of autologous blood might minimize the risk of perioperative transfusion, but studies have unexpectedly shown similar postoperative infectious complications and cancer recurrence and/or survival rates in patients receiving autologueous blood donated before operation and those receiving allogeneic blood.
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Testosterone: the crucial hormone responsible for depressing myocardial function in males after trauma-hemorrhage.
Dierk E. Remmers,William G. Cioffi,Kirby I. Bland,Ping Wang,Martin K. Angele,Irshad H. Chaudry +5 more
TL;DR: Testosterone antagonism in males might be an effective approach for maintaining myocardial function after adverse circulatory conditions and Although testosterone depletion in male trauma victims is neither practical nor advocated, testosterone receptor blockade after trauma may represent a novel and useful adjunct for maintaining normal myocardials performance under those conditions.
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Critical Role of Oxygen Radicals in the Initiation of Hepatic Depression after Trauma Hemorrhage
TL;DR: The data suggest that ROS play a role in producing the depression in organ functions after severe hemorrhagic shock and adjuncts that attenuate the detrimental effects of ROS may be useful for improving the depressed cardiac and hepatocellular functions after trauma hemorrhage and resuscitation.
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Resuscitation after uncontrolled venous hemorrhage: Does increased resuscitation volume improve regional perfusion?
TL;DR: Fuid resuscitation after uncontrolled venous bleeding transiently increased cardiac output and mean arterial blood pressure compared with nonresuscitated animals and moderate instead of no resuscitation or larger volume of resuscitation is recommended in an uncontrolled model of venous hemorrhage.
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Resuscitation regimens for hemorrhagic shock must contain blood.
TL;DR: It is hypothesized that RES from HS with crystalloid solutions alone aggravate the endothelial cell dysfunction and this hypothesis is applied to hemorrhagic shock patients with central giant cell dysfunction.
References
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Journal Article
Trauma. Accidental and intentional injuries account for more years of life lost in the U.S. than cancer and heart disease. Among the prescribed remedies are improved preventive efforts, speedier surgery and further research.
Journal ArticleDOI
Hypothermia: Pathophysiology, Clinical Settings, and Management
TL;DR: The physiology of thermoregulation is important in light of recent advances in therapy using core rewarming, and pathophysiology, etiology and management of the hypothermia syndrome are reviewed.
Journal ArticleDOI
Fluid Therapy in Hemorrhagic Shock
TL;DR: The role of cardiac output, blood volume, and peripheral resistance in hemorrhagic shock has been well studied, but changes in the extravascular extracellular fluid and in fluid and electrolytes within the cell, invoked by hemorrhagicshock, have received relatively little attention.
Journal ArticleDOI
Antibody to Hepatitis B Core Antigen as a Paradoxical Marker for Non-A, Non-B Hepatitis Agents in Donated Blood
Deloris E. Koziol,Paul V. Holland,David W. Alling,Jacqueline C. Melpolder,Rachel Solomon,Robert H. Purcell,Lenita M. Hudson,Frances J. Shoup,Henry Krakauer,Harvey J. Alter +9 more
TL;DR: The relationship between the presence of antibody to hepatitis B core antigen (anti-HBc) in donor blood and the development of hepatitis in recipients of that blood was studied and surrogate tests for non-A, non-B virus carriers must be seriously considered.
Journal ArticleDOI
Transfusion-associated fatalities: review of bureau of biologics reports 1976-1978
C L Honig,J. R. Bove +1 more
TL;DR: Review of the 70 transfusion‐associated fatalities reported to the Bureau of Biologics between 1976 and 1978 revealed 44 acute hemolytic reactions, two delayed hemolytics reactions, five fatalities associated with acute respiratory failure, two cases of bacterial contamination, one graft‐versus‐host reaction (GVHR), ten cases of hepatitis, and six fatalities not associated with transfusion.
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