Current methods of emergency fluid resuscitation in the pre-hospital setting are inadequate due to the large volumes required of convention resuscitation solutions. Recent research by us and other suggest that exceedingly small volumes of highly hperosmotic formulation can safely and rapidly restore blood pressure, cardiac output and oxygen consumption after moderate hemorrhage. The overall goal of the proposed research is to better understand the physiological mechanisms of action of small volume hypertonic resuscitation. Towards this goal we will measure the integrated cardiopulmonary response to infusion of hypertonic fluids in normovolemic and hypovolemic animals.
Specific Aims are: 1) to measure the cardiac function before and after hypertonic infusions in normovolemic and hemorrhaged animals. direct and indirect effects of hypertonic saline will be evaluated for the augmentation of cardiovascular performance after hypertonic resuscitation. 2) to better understand the rapid natriuresis/diuresis observed after hypertonic resuscitation. We will sequentially evaluate if the natriuresis is induced through atria natriuretic peptide or the intrarenal production of postaglandins and brandykinins. 3) to provide consultant and analytical support to ongoing and planned clinical trials of 7.5 NaCl/6% dextran 70 for resuscitation of trauma. We will measure the integrated cardiovascular response in a dynamic hemorrhage model designed to mimic the clinical setting.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
7R01HL040296-03
Application #
3357382
Study Section
Surgery, Anesthesiology and Trauma Study Section (SAT)
Project Start
1989-03-01
Project End
1992-02-28
Budget Start
1990-10-01
Budget End
1991-02-28
Support Year
3
Fiscal Year
1990
Total Cost
Indirect Cost
Name
University of Texas Medical Br Galveston
Department
Type
Schools of Medicine
DUNS #
041367053
City
Galveston
State
TX
Country
United States
Zip Code
77555
Kien, N D; Moore, P G; Pascual, J M et al. (1997) Effects of hypertonic saline on regional function and blood flow in canine hearts during acute coronary occlusion. Shock 7:274-81
Moon, P F; Hollyfield-Gilbert, M A; Myers, T L et al. (1996) Fluid compartments in hemorrhaged rats after hyperosmotic crystalloid and hyperoncotic colloid resuscitation. Am J Physiol 270:F1-8
Moon, P F; Kramer, G C (1995) Hypertonic saline-dextran resuscitation from hemorrhagic shock induces transient mixed acidosis. Crit Care Med 23:323-31
Frischmeyer, K J; Moon, P F (1994) Evaluation of quantitative acid-base balance and determination of unidentified anions in swine. Am J Vet Res 55:1153-7
Moon, P F; Hollyfield-Gilbert, M A; Myers, T L et al. (1994) Effects of isotonic crystalloid resuscitation on fluid compartments in hemorrhaged rats. Shock 2:355-61
Halvorsen, L; Roth, R; Gunther, R A et al. (1993) Liver hemodynamics during portal venous endotoxemia in swine. Circ Shock 41:166-75
Kien, N D; Kramer, G C; White, D A (1991) Acute hypotension caused by rapid hypertonic saline infusion in anesthetized dogs. Anesth Analg 73:597-602
Kien, N D; Reitan, J A; White, D A et al. (1991) Cardiac contractility and blood flow distribution following resuscitation with 7.5% hypertonic saline in anesthetized dogs. Circ Shock 35:109-16
Moon, P F; Snyder, J R; Haskins, S C et al. (1991) Effects of a highly concentrated hypertonic saline-dextran volume expander on cardiopulmonary function in anesthetized normovolemic horses. Am J Vet Res 52:1611-8
Halvorsen, L; Bay, B K; Perron, P R et al. (1990) Evaluation of an intraosseous infusion device for the resuscitation of hypovolemic shock. J Trauma 30:652-8;discussion 658-9