Hemodynamic responses to fluid resuscitation after XXXX .

@entity1707 @entity64 @entity1508 @entity174 @entity7825 @entity26 @entity880 @entity551 @entity130
OBJECTIVES: To determine the acute circulatory effects of an open @entity174 and the circulatory effects of different fluid resuscitation strategies after such a @entity174 . DESIGN: Randomized controlled laboratory study. SETTING: Medical Research Council laboratory, university medical school. SUBJECTS: Four groups of ten immature female Large-White @entity1707 (16.5-27.0 kg): those receiving limited resuscitation, moderate resuscitation, and normal resuscitation, as well as surgical controls. INTERVENTIONS: After induction and intubation with 3% @entity1508 , anesthesia was maintained with intravenous Saffan. Cannulae were placed in the left external jugular vein and both axillary arteries. A pulmonary artery flotation catheter was introduced through the jugular cannula. The left femur was exposed for @entity174 with a captive bolt. Resuscitation was with 0.9% saline; the moderate resuscitation group received less than the normal resuscitation group (840 +/- 67 mL vs. 1873 +/- 96 mL), whereas the surgical control and limited resuscitation groups received the lowest volumes (466 +/- 10 mL and 452 +/- 19 mL, respectively). MEASUREMENTS AND MAIN RESULTS: Measurements/calculations of global hemodynamics (intravascular pressures, e.g., mean arterial pressure, heart rate, @entity64 volume index, cardiac output/index, left @entity64 work index, and systemic vascular resistance index), metabolism ( @entity26 delivery index and consumption index, @entity26 extraction ratio, plasma @entity880 , @entity7825 ), blood gases, pH, and hematocrit were made before @entity174 , immediately and 30 mins after @entity174 , and at 30-min intervals for the next 4 hrs. Hind-limb muscle water content was determined by dessication. @entity174 led to acute reductions in cardiac output/index, @entity64 volume index, and @entity26 delivery index and increases in systemic vascular resistance index and @entity26 extraction ratio. In the absence of fluid resuscitation, these changes persisted and were accompanied by @entity551 . Normal resuscitation attenuated the @entity174 -induced changes such that the only differences during resuscitation between limited resuscitation and normal resuscitation were a reduction in hematocrit in the latter and an increase in @entity26 extraction ratio in the former. Water content increased in both injured and uninjured muscle. CONCLUSIONS: The cardiovascular and metabolic changes associated with femur @entity174 in the anesthetized @entity1707 can be reversed or prevented by crystalloids given in a volume equivalent to Advanced @entity130 Life Support guidelines.
