Blood Loss and Transcapillary Refill in Uncontrolled Treated Hemorrhage in Dogs

Abstract

OBJETIVE: This study evaluated retroperitoneal hematomas produced by bilateral injury of iliac arteries (uncontrolled hemorrhage), blood volume loss, transcapillary refill, the effects of volume replacement on retroperitoneal bleeding and the hemodynamic changes with and without treatment. METHODS: Initial blood volume was determined with Tc 99m-labelled red cells, and bleeding was evaluated by means of a portable scintillation camera positioned over the abdomen. Previously splenectomized mongrel dogs (16.8 ± 2.2 kg) were submitted to hemorrhage for 30 minutes and randomized into three groups: I-no treatment (n=7); II-treatment with 32 mL/kg of Lactated Ringer's for three to five minutes (n=7); and IIItreatment with 4 mL/kg of 7.5% NaCl plus 6.0% dextran 70 for three to five minutes (n=7). They were studied for an additional 45 minutes. RESULTS: Volume replacement produced transitory recovery in hemodynamic variables, including mean pulmonary artery pressure, pulmonary capillary wedge pressure and cardiac index, with significant increase in dogs treated with 32 mL/kg of Lactated Ringer's and 7.5% NaCl plus 6.0% dextran 70 (p<0.001, against no treatment), along with a decrease (p<0.001) in the systemic vascular resistance index. Groups II and III had significant initial decreases in hematocrit and hemoglobin. The treated dogs (groups II and III) presented rebleeding, which was greater during treatment with 32 mL/kg of Lactated Ringer's (group II). CONCLUSIONS: Despite the rebleeding observed in treated groups, the utilization of hypertonic saline solution with dextran proved to be effective in the initial reanimation, producing evident transcapillary refill, while the Lactated Ringer's solution produced capillary extravasation and was ineffective in the initial volume replacement in this model of uncontrolled hemorrhage.

Nursing diagnoses in trauma victims with fatal outcomes in the emergency scenario

“…NDs encountered in at least 50.0% of the fatalities, repercussions and consequences for the body, as well as the high incidence of mortality (17) . In the above study, 175 victims were analyzed and of these, 63 (30.6%) suffered death, with 50.8% up to 6 hours post-event, which shows the importance of developing studies that analyze the post-trauma period.…”

“…The risk for shock represented by hypotension/hypovolemia/ hypoxia/increased or decreased heart rate and the trauma itself is a common situation among victims of external causes, especially those with abdominal/ thoracic injuries and with traumatic amputations of lower limbs and exposed fractures (16)(17) .…”

“…Furthermore, considering that a single ND would not be sufficient to define an outcome, it was considered appropriate to Another way to interpret the findings could reveal the pathophysiological alterations resulting from the inadequate oxygen supply to the body that can result from numerous causes, and the alterations in perfusion in various organs and tissues, as a result of hypoxia or hypoxemia, lead to the outcome of death (3,17) . This nursing diagnoses provide the basis for the selection of nursing interventions to achieve results for which the nurse is responsible (8,18) .…”