토끼에서 급성출혈성 쇽시 전해질용액 종류에 따른 비교

Abstract

Background: The purpose of this study is to evaluate what kind of crystalloid solution could function as the best buffer and correct the metabolic acidosis most effectively in rabbits with hemorrhagic shock.

Methods: Twenty eight rabbits were bled until mean arterial pressure(MAP) became 70% of control. Thirty minutes after hemorrhagic shock fluid resuscitation was started with either plasmalyte or Hartmann's solution or 0.9% normal saline until MAP returned to 90% of the control. Hemodynamic and blood gas study, plasma lactate and electrolyte concentration were measured before, during, and 30 minutes after recovery from shock.

Results: The amount of shed blood to reduce MAP to 70% of control ranged 76∼87 ml. And the volume for fluid resuscitation was 274∼324 ml. There was no statistically significant difference among the three groups. The pH decreased during shock in all group and still decreased after resuscitation in Hartmann's solution and normal saline. But it increased significantly after resuscitation in plasmalyte. Lactate was increased in all group during shock and decreased by 22 and 23 mg/dl after resuscitation in plasmalyte and normal saline. But it still increased by 40 mg/dl in Hartmann's solution. Serum potassium level decreased significantly after resuscitation with normal saline. Serum calcium level decreased significantly after resuscitation with plasmalyte and normal saline.

Conclusion: With the above results the plasmalyte which has pH closer to that of normal blood might be able to avoid the metabolic acidosis and maintain acid-base equilibrium effectively after fluid resuscitation in acute hemorrhagic shock.