The effect of ethanol on survival time in hemorrhagic shock in an unanesthetized swine model

• Published in: Annals of emergency medicine Vol. 17; no. 1; pp. 15 - 19
• Main Authors: Zink, Brian J, Syverud, Scott A, Dronen, Steven C, Barsan, William G, Van Ligten, Peter, Timerding, Beverly L
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 1988; Elsevier
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Biological and medical sciences; Blood Pressure - drug effects; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Ethanol - blood; Ethanol - pharmacology; ethanol, effect on survival time; Female; Intensive care medicine; Medical sciences; Models, Biological; Prognosis; shock, hemorrhage, effect of ethanol; Shock, Hemorrhagic - physiopathology; Swine; Time Factors; ethanol, effect on survival time; shock, hemorrhage, effect of ethanol; Shock; Vertebrata; Experimental disease; Mammalia; Ethanol; Artiodactyla; Hemorrhage; Survival; Ungulata; Resuscitation; Pig
• ISSN: 0196-0644; 1097-6760
• DOI: 10.1016/S0196-0644(88)80496-7

Controversy exists as to whether ethanol intoxication causes exaggerated hypotension or increased mortality during hemorrhagic shock. Previous studies have used anesthetized animals. This limits data interpretation as anesthetic agents, particularly pentobarbital, have well-documented effects on hemodynamics and the response to hemorrhage. We studied the effects of moderate ethanol intoxication on blood pressure and survival time during fatal hemorrhagic shock in unanesthetized swine. Immature female swine weighing 15 to 20 kg were splenectomized and instrumented with chronic indwelling aortic catheters, right atrial catheters, and gastrostomy tubes. Four to seven days later the unanesthetized animals underwent hemorrhagic shock. Thirty minutes prior to the start of hemorrhage, the experimental group (n = 8) received 3 mL/kg of 100% ethanol mixed as a 1:3 solution with water through a gastrostomy tube. The control group (n = 8) received an equal amount of water. The distal aortic catheter was connected to a roller pump and blood was removed at a rate of 1 mL/kg/min until the animal died. Arterial pressure, heart rate, lactate ethanol and glucose levels, hematocrit, and arterial blood gases were measured in both groups at baseline and every 15 minutes thereafter. A mean ethanol level of 1,500 to 1,700 μg/mL was produced in the experimental group from baseline through 60 minutes. Data were analyzed using Student's two-tailed t test, and analysis of variance for repeated measures. There was no significant difference in survival time between the control (63.1 ± 2.8 min) and ethanol (59.9 ± 5.9 min) groups. Systolic blood pressure was significantly lower in the ethanol group after 15 minutes of hemorrhage (81 ± 22 to 59 ± 14 mm Hg, P < .05). Hematocrit was significantly higher in the ethanol group at time 15 minutes. No significant differences were found in any of the other hemodynamic or metabolic parameters. The results of our study show that in unanesthetized swine moderate ethanol intoxication causes increased hypotension early in hemorrhagic shock, but does not significantly affect survival time.