The Use of Hypertonic Solutions to Resuscitate Animals from Hypovolemic Shock.

The purpose of this contract was to evaluate small volume resuscitation of animals subjected to moderately severe hemorrhagic shock. The stimulus for this study was the observation that many soldiers who die preventable deaths after suffering injuries die from uncontrolled hemorrhagic shock. Resuscitation of soldiers in the field is difficult, in part, because of the necessity to infuse large volumes of isotonic resuscitative solutions. This proposal evaluated the use of very small volumes of hyperosmotic solutions. The proposal began by evaluating different compositions for hyperosmotic solutions and ended with an evaluation of the solution that appeared the most promising. We found that 2,400 milliosmolar sodium chloride with 6% Dextran 70 was highly effective in resuscitating animals that had lost up to 60% of their blood volume. The amount of solution necessary to restore and maintain cardiac index and blood pressure was on the order of 1/5 the amount of blood loss from the hemorrhagic insult. These solutions appear particularly promising because they are inexpensive, require no cross matching, are effective when used in small volumes, are easy to store, and should keep indefinitely as they will not support bacterial growth.