Crystalloid resuscitation in hemorrhagic shock

Application of pulsed arterial resuscitation in a rabbit model of hemorrhagic shock

“…However, because of its complex nature and risk of adverse reactions such as vasospasm and limb ischemia, it is currently only used as a backup plan in cases of severe shock, acute blood loss, near-death state, and clinical death. [6,17,27] In this study, during the process of preparing the hemorrhagic shock model, the average blood loss of the experimental animals was 25 mL/kg, and MAP decreased to 50% of the baseline value and stabilized at approximately 50 mmHg. MAP, pulse pressure, urine output, and blood lactate levels showed significant changes, indicating that the model met the requirements and was accurate.…”

“…[15,24] The direct supply of blood to the brain through the carotid tissues is beneficial to the recovery of vital medullary life functions, consequently improving the functioning of the central nervous system, especially that of the cortex and subcortical regions and thereby restoring the regulatory functions that were initially interfered with. [27,30] As the blood is infused under added arterial pressure, which does not rely on the function of the heart that is already fragile, the burden placed on the heart is relieved. Furthermore, because the infused arterial blood can directly flow into the coronary arteries, this also alleviates the myocardial ischemia and facilitates the recovery of cardiac function.…”

“…Furthermore, because the infused arterial blood can directly flow into the coronary arteries, this also alleviates the myocardial ischemia and facilitates the recovery of cardiac function. [27,30] The blood that flows through the aorta quickly enters the kidneys, gastrointestinal tract, and other organs, thus increasing the blood perfusion, protecting the function of the internal organs, and slowing down the systemic inflammatory response syndrome, as well as reducing the risks of intestinal bacterial translocation and intestinal endotoxemia. Because the transfused blood in the artery flows retrogradely, it forms turbulences in the large vessels (similar to ventricle turbulence), which helps to mix the blood thoroughly.…”

“…This helps reduce ischemia and reperfusion injury and can hence help reduce the risks of visceral and pulmonary edemas. [13,27,30] Moreover, the pressurized transfusion of arterial blood constantly stimulates the vessel walls, including the chemical receptors and baroreceptors of the aortic arch and carotid sinus. The reflex protection system of the body and the vagal reflex from the direct stimulation of blood on the arterial wall can result in a significant elevation of arterial pressure [29,31] and lead to high blood pressure at the arterial end of the capillaries, which helps reduce capillary congestion.…”

“…This reduces the blood pressure fluctuations as well as the interference on the hemodynamics and on the body's own regulation during the buffering period. [22,32] Lastly, blood (especially autologous blood, including uncontaminated body cavity blood and frozen plasma extracted and prepared in advance from high-risk groups such as soldiers) [25][26][27] has always been considered the best and most effective resuscitation solution. Apart from momentarily increasing blood volume and reducing apoptosis, the blood can moreover supplement coagulation factors, which help control bleeding.…”