Abstract 330: Fluid Resuscitation Guided by Sublingual PCO2 During Hemorrhagic Shock in Swine
Introduction: Aggressive fluid resuscitation during hemorrhagic shock to restore normal levels of aortic pressure often results in volume overload. We investigated whether fluid resuscitation guided by sublingual PCO2 (PslCO2) would minimize volume overload without compromising the outcomes of hemorrhagic shock.
Hypothesis: Fluid resuscitation guided by PslCO2 reduces the volume of fluid resuscitation without compromising the outcomes of hemorrhagic shock when compared with the fluid resuscitation guided by blood pressure (BP).
Methods: Ten male domestic pigs weighing between 34-37 kg were utilized. Forty-five percent of estimated blood volume (EBV) was removed over an interval of 1 hour. The animals were then randomized to receive fluid resuscitation based on either PslCO2 or BP. In the PslCO2 guided group, resuscitation was initiated when PslCO2 exceeded 70 mm Hg and stopped when it decreased to 50 mm Hg. In the BP guided group, resuscitation was initiated when mean aortic pressure decreased to 60 mm Hg and stopped when it increased to 90 mm Hg. Ringer’s lactate solution (RLS) of 30 ml/kg was infused and followed with the shed blood if needed. All animals were observed for 72 hours.
Results: In the PslCO2 guided group, fluid resuscitation was required in only 2 animals with a significantly low volume of RLS without the need of blood infusion. However, in the BP guided group, all animals required a significantly larger volume of fluid including both RLS and blood. There were no differences in the 72 hours of survival and neurological alertness score between groups (Table).
Conclusion: During hemorrhagic shock, fluid resuscitation guided by PslCO2 significantly reduced the amount of resuscitation fluid without compromising the outcomes of hemorrhagic shock.
- © 2012 by American Heart Association, Inc.