Fluid ressusicitation in uncontrolled hemorrhagic shock model after massive splenic trauma

34 SUMMARY Traumatic injury of spleen and accopmanying uncontrolable hemorrahgic shock is frequently seen in major traumas. In management of these patients, initial fluid resusitation should be done and in the presence of worsening symptoms splenectomy should be performed. The composition and the amount of fluid to be used in fluid resusistation is still controversial. In this study we aimed to find out whether there is a difference between fluids used in uncontrolable hemorrhagic shock caused by massive trauma related splenic injury A total of 42 male Spraque-Dawley rats were divided into 7 groups, 6 rats in each group: Group 1 served as control: followed up without any intervention. Group 2 (shock), shock protocol was applied and followed up. In all ather groups after administration of shock protocols fluid resusitation was done at 15. minutes and splenectomy was performed at 45. minutes. Group 3 (Shock & %7.5 NaCI ): % 7.5 NaCI solution infusion at a rate of 7.5 ml/kg/h, Group 4 (Shock & RL 35 1): RL solution infusion at a rate of 35 ml/kg/h Group 5 (Shock & RL 70 1): RL solution Infusion at a rate of 70 ml/kg/h Group 6 (Shock & % 0.9 NaCI 35 ): % 0.9 NaCI solution infusion at a rate of 35 ml/kg/h Group 7 (Shock & % 0.9 NaCI 70 ): % 0.9 NaCI solution infusion at a rate of 35 ml/kg/h was a administered. In all groups hematocrite were measured in 0, 15, 30, 45, 60 ve 120. minutes, Pulse and mean arterial pressures were recorde at 0, 15, 30, 45, 60, 75,35 100 ve 120.minutes. Except control and head trauma groups, Postmortem laparatomy was done to all rats and the amount of hemorrage was determined. We found that in group 4 and 5, the vital signs and viability at 120 minutes were significantly different than groups (p<0.05). As a result, decreasing bleeding amount and increasing viability should be expected instead of increasing mean arterial pressure in desicion of fluid composition in uncontroleable hemorrhagic shock cases. In means of composition of fluid used in fluid resusitation RL was found to be more effective than other fluids and among RL used groups lower doses of Rl was found to be more effective than higher doses.