Fluid administration rate for uncontrolled intraabdominal hemorrhage in swine

Abstract

Background: We hypothesized that slow crystalloid resuscitation would result in less blood loss and a smaller hemoglobin decrease compared to a rapid resuscitation during uncontrolled hemorrhage.

Methods: Anesthetized, splenectomized domestic swine underwent hepatic lobar hemitransection. Lactated Ringers was given at 150 or 20 mL/min IV (rapid vs. slow, respectively, N = 12 per group; limit of 100 mL/kg). Primary endpoints were blood loss and serum hemoglobin; secondary endpoints included survival, vital signs, coagulation parameters, and blood gases.

Results: The slow group had a less blood loss (1.6 vs. 2.7 L, respectively) and a higher final hemoglobin concentration (6.0 vs. 3.4 g/dL).

Conclusions: Using a fixed volume of crystalloid resuscitation in this porcine model of uncontrolled intraabdominal hemorrhage, a slow IV infusion rate produced less blood loss and a smaller hemoglobin decrease compared to rapid infusion.

Fig 1. Experiment flow chart.

Swine were acclimatized (acclim), then on the procedure day underwent general endotracheal anesthesia (GETA), followed by access of the carotid and jugular vessels (Vasc Acc), and then other preparatory procedures. After injury, subjects underwent IV crystalloid resuscitation (maximum volume allowed = 100 mL/kg) for the indicated observation period (Obs). Red bar underneath each observation period indicates relative time required for crystalloid infusion.