Effects of traditional versus delayed resuscitation on serum lactate and base deficit

• Published in: Resuscitation Vol. 43; no. 1; pp. 39 - 46
• Main Authors: Baron, Bonny J, Sinert, Richard H, Sinha, Anil K, Buckley, Marie C, Shaftan, Gerald W, Scalea, Thomas M
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.12.1999; Elsevier
• Subjects: Acid-base; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Biological and medical sciences; Blood Pressure; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Female; Hemodynamics; Hemorrhage; Intensive care medicine; Lactate; Lactic Acid - blood; Medical sciences; Resuscitation; Resuscitation - methods; Shock; Shock, Hemorrhagic - blood; Shock, Hemorrhagic - therapy; Swine; Time Factors; Shock; Hemodynamics; Lactate; Hemorrhage; Acid-base; Resuscitation; Prognosis; Deficiency; Cardiovascular disease; Acid base balance disorder; Pig; Vascular disease; Lactates; Metabolic disorder; Vertebrata; Mammalia; Animal; Complication; Delay time; Artiodactyla; Ungulata
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/S0300-9572(99)00122-7

Objective: To test the hypothesis that delayed resuscitation of hemorrhagic shock produces a less severe shock insult than traditional resuscitation, characterized by repeated episodes of alternating hypotension and normotension. Methods: Female pigs were divided into three groups. Sham operated controls (C) ( n=4), sustained hypotension (SS) ( n=6), and hypotension with multiple cycles of shock and resuscitation (SR) ( n=6). SS and SR animals were bled to a mean arterial pressure (MAP) of 50 mmHg. SS animals were maintained at an MAP of 50 mmHg for 65 min and then resuscitated to baseline blood pressure with normal saline and shed blood. SR animals were initially bled and maintained at an MAP of 50 mmHg for 35 min, resuscitated to baseline BP, and subsequently bled and resuscitated twice more. The total period of shock was the same in both SS and SR. Results: Following hemorrhage, there was a significant increase in lactate and base deficit in SS as compared to C and SR. Conclusion: Delayed resuscitation produces a more profound shock insult than traditional resuscitation.