Low-dose hypertonic saline (NaCl 8.0%) treatment of uncontrolled abdominal hemorrhage: effects on arterial versus venous injury

The present study compared hemodynamic response to hypertonic saline (HTS; NaCl 8.0%) treatment of uncontrolled hemorrhage from a stab injury in the abdominal aorta (A) or vena cava (V), respectively. The hypothesis was challenged that adverse effects of HTS treatment is dependent on the pressure load in the lesioned vessel. Uncontrolled hemorrhage was produced in anesthetized rats by vessel puncture with a syringe needle. After 10 min of hemorrhage, subjects were randomized to HTS infusion, 2.0 mL/kg i.v. given at .4 mL/min (AHTS, n = 10 and VHTS, n = 10), or to no treatment (AC, n = 12 and VC, n = 7). mean arterial pressure (MAP), heart rate, plasma electrolytes, protein, and hematocrit were recorded continuously for 240 min. HTS treatment produced MAP elevation but did not influence the final outcome in either A or V lesions. Thus, evidence of worsened outcome related to HTS treatment was not confirmed. However, one-half of all subjects with arterial hemorrhage died, compared to only 1 of 17 subjects with venous hemorrhage. Spontaneous MAP recovery during hemorrhage, and MAP response to HTS treatment, were shown to have predictive value for survival.