Crystalloid versus colloid resuscitation in a lethal rat model of trauma/hemorrhagic shock

Abstract

Hemorrhagic shock due to trauma is a leading cause of death. Controversy of which resuscitative fluid may be best to provide adequate tissue perfusion and prevent post‐resuscitation complications still exists. The purpose was to emphasize the superiority of fresh frozen plasma as a resuscitative fluid which restores acid base equilibrium with less volume and lower mortality. Sprague Dawley rats were subjected to trauma and hemorrhagic shock (MAP of 35mmHg) until decompensation. Resuscitation was done with lactated Ringer's (LR, n=15) or fresh frozen rat plasma (FFP, n=16) to maintain MAP at 80mmHg over 3 hours. Total volume of fluid infused were recorded and compared. Metabolic and hemodynamic parameters and tissue H2O content were measured. The volume of blood removed was not different between groups (10ml) nor was time to initiate resuscitation (LR:53±2min, FFP:58±2min). Fluids were able to restore and achieve the target MAP. Mortality was 47% LR and 6% in FFP. However in the surviving animals the volume of LR necessary to achieve target MAP was 7 times the volume of blood loss, whereas 1.1 times was required for FFP. Buffer capacity of FFP was better than LR based upon correction of pH and base excess. Wet‐to‐dry ratios of lung, skin and muscles were reduced with FFP when compared to LR. LR restored normal hemodynamic conditions; however FFP is more efficient and required less volume. (UT Health Houston‐CETIR Dept. Grant)