Further Evaluation of the Effects of 7.5% NaCl/6% Dextran-70 (HSD) administration on Coagulation and Platelet Aggregation in Hemorrhaged and Euvolemic Swine

Dubick, Michael A.; Kilani, Ahmed F.; Summary, James J.; Greene, Jacob; Wade, Charles E.

doi:10.21236/ada266477

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…Earlier work on dextrans has also suggested that there could be cross matching problems in patients who have received dextran prior to venepuncture. Work (Dubick et al, 1993b) on HSD, however, looked at several haemostatic analytes including platelet counts, PT, APTT, and Von Willebrand's factor antigen and found no difference unless more than 7.5% of blood volume was replaced (Tan et al, 2002).…”

Section: Haematologicalmentioning

confidence: 99%

The role of hypertonic saline dextran in trauma resuscitation

Perera

Porter

2002

Trauma

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AM Perera and KM PorterModern trauma management has recognized the importance of using conserva-tive¯uid resuscitation regimes in order to prevent complications from¯uid overload arising. Hypertonic/hyperoncotic¯uids appear to provide an ideal means of facilitating this, requiring only small volumes to rapidly elevate blood pressure. Hypertonic saline dextran (HSD) was introduced in 1985 but its take up has been slow, a large part of this has been due to the lack of human trials and concerns about complications.The current evidence has been reviewed and it is clear that HSD is an ef® cient means of correcting hypotension, doing so mainly by the mobilizing endogenous water. It is becoming apparent that early administration has the potential to modulate the in¯ammatory cascade in patients at risk of developing adult respiratory distress syndrome (ARDS) and multiorgan failure. This is re¯ected in the handful of human trials that show a trend towards increased survival (particularly for head injuries) and a possible reduction in ARDS. The side effect pro® le appears to be good, even in the presence of dehydration or penetrating trauma.Published human trials have methodological problems and lack of power of study this has led to a reliance on animal studies. Clearly there is great potential, but before large-scale prehospital usage can be justi® ed further well-conducted randomized human trials are needed. Downloaded from permeability increase and plasma volume loss induced by endotoxin was attenuated by hypertonic saline with or without dextran. Shock 12(1): 75±80. Diebel LN, Tyburski JG, Dulchavsky SA. 1998. Effect of hypertonic saline solution and dextran on ventricular blood¯ow and heart±lung interaction after hemorrhagic shock. Surgery 124(4): 642±49; discussion 649±50. Doyle JA, Davis DP, Hoyt DB. 2001.The use of hypertonic saline in the treatment of traumatic brain injury. J Trauma 50(2): 367±83. Dubick MA, Summary JJ, Ryan BA, Wade CE. 1989. Dextran concentrationsin plasma and urine following administration of 6% dextran-70= 7.5% NaCl to hemorrhaged and euyolemic conscious swine. Circ Shock 29(4): 301±10. Dubick MA, Zaucha GM, Korte DW Jr, Wade CE. 1993a. Acute and subacute toxicity of 7.5% hypertonic saline-6% dextran-70 (HSD) in dogs. 2. Biochemical and behavioral responses.J Appl Toxicol 13(1): 49±55. Dubick MA, Kilani AF, Summary JJ et al. 1993b. Further evaluation of the effects of 7.5%NaCl= 6% Dextran-70 administration on coagulation and platelet aggregation in haemorrhaged and envolaemic swine. Circ Shock 40: 200±205. Dubick MA, Wade CE. 1994.A review of the ef®cacyand safety of 7.5% NaCl= 6% Dextran 70 in experimental animals and humans. J Trauma 36(3): 323±30. Dubick MA, Davis JM, Myers T, Wade CE, Kramer GC. 1995. Dose response effects of hypertonic saline and dextran on cardiovascular responses and plasma volume expansion in sheep. Shock 3(2): 137±44. Elgjo GI, Mathew BP, Poli Di Figueriedo LF et al. 1998. Resuscitation with HSD improves cardiac function in vivo and ex vivo after burn injury in shee...

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Section: Haematologicalmentioning

confidence: 99%

The role of hypertonic saline dextran in trauma resuscitation

Perera

Porter

2002

Trauma

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Hypertonic saline: a clinical review

et al. 2007

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Literature suggest that hypertonic saline (HTS) solution with sodium chloride concentration greater than the physiologic 0.9% can be useful in controlling elevated intracranial pressure (ICP) and as a resuscitative agent in multiple settings including traumatic brain injury (TBI). In this review, we discuss HTS mechanisms of action, adverse effects, and current clinical studies. Studies show that HTS administered during the resuscitation of patients with a TBI improves neurological outcome. HTS also has positive effects on elevated ICP from multiple etiologies, and for shock resuscitation. However, a prospective randomized Australian study using an aggressive resuscitation protocol in trauma patients showed no difference in amount of fluids administered during prehospital resuscitation, and no differences in ICP control or neurological outcome. The role of HTS in prehospital resuscitation is yet to be determined. The most important factor in improving outcomes may be prevention of hypotension and preservation of cerebral blood flow. In regards to control of elevated ICP during the inpatient course, HTS appears safe and effective. Although clinicians currently use HTS with some success, significant questions remain as to the dose and manner of HTS infusion. Direct protocol comparisons should be performed to improve and standardize patient care.

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"Efeitos da solução salina hipertônica na reperfusão hepática em pacientes submetidos ao transplante do fígado"

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Further Evaluation of the Effects of 7.5% NaCl/6% Dextran-70 (HSD) administration on Coagulation and Platelet Aggregation in Hemorrhaged and Euvolemic Swine

Cited by 3 publications

References 16 publications

The role of hypertonic saline dextran in trauma resuscitation

The role of hypertonic saline dextran in trauma resuscitation

Hypertonic saline: a clinical review

"Efeitos da solução salina hipertônica na reperfusão hepática em pacientes submetidos ao transplante do fígado"

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