Abstract
Previous studies found that seawater immersion combined with hemorrhagic shock (SIHS) induced serious organ function disorder, and lethal triad was a critical sign. There were no effective treatments of SIHS. Fluid resuscitation was the initial measurement for early aid following hemorrhagic shock, while the proper fluid for SIHS is not clear. Effects of different osmotic pressures [lactated Ringer’s (LR) solution, 0.3% saline, 0.6% saline, and 0.9% normal saline] on the lethal triad, mitochondrial function, vital organ functions, and survival were observed following SIHS in rats. The results showed that SIHS led to an obvious lethal triad, which presented the decrease of the body temperature, acidosis, and coagulation functions disorder in rats. Fluid resuscitation with different osmotic pressures recovered the body temperature and corrected acidosis with different levels; effects of 0.6% normal saline were the best; especially for the coagulation function, 0.6% normal saline alleviated the lethal triad significantly. Further studies showed that SIHS resulted in the damage of the mitochondrial function of vital organs, the increase of the vascular permeability, and, at the same time, the organ function including cardiac, liver, and kidney was disordered. Conventional fluid such as LR or 0.9% normal saline could not improve the mitochondrial function and vascular leakage and alleviate the damage of the organ function. While moderate hypotonic fluid, the 0.6% normal saline, could lighten organ function damage via protecting mitochondrial function. The 0.6% normal saline increased the left ventricular fractional shortening and the left ventricular ejection fraction, and decreased the levels of aspartate transaminase, alanine transferase, blood urea nitrogen, and creatinine in the blood. The effects of fluids with different osmotic pressures on the mean arterial pressure (MAP) had a similar trend as above parameters. The survival results showed that the 0.6% normal saline group improved the survival rate and prolonged the survival time, the 72 h survival rate was 7/16, as compared with the LR group (3/16). The results indicate that appropriate hypotonic fluid is suitable after SIHS, which alleviates the lethal triad, protects the mitochondrial function and organ functions, and prolongs the survival time.
Highlights
Hemorrhagic shock is a comprehensive syndrome of the dysfunction of the systemic microcirculation, which led to serious impairment of vital organs due to the decrease of effective circulating blood volume and insufficient perfusion of tissue following traumatic injury (Mauriz et al, 2007; Torres Filho, 2017)
Our preliminary studies found that several pathophysiological parameter disorders were presented following the seawater immersion combined with hemorrhagic shock (SIHS), such as high incidence of the lethal triad and dysfunction of multiple organs, and electrolyte disturbance, which led to high mortality and brought large challenges to the emergency treatment
Effects on Acidosis Acidosis is the accumulation of acid in blood or tissues, which is considered a vital factor resulting in organ function disorder (Lim, 2007; Ahmed et al, 2019)
Summary
Hemorrhagic shock is a comprehensive syndrome of the dysfunction of the systemic microcirculation, which led to serious impairment of vital organs due to the decrease of effective circulating blood volume and insufficient perfusion of tissue following traumatic injury (Mauriz et al, 2007; Torres Filho, 2017). With the maritime performance becoming frequent, sea immersion combination with injury presented more. Previous reports demonstrated that there was a series of pathophysiological characteristics following seawater immersion injury, such as microcirculation disturbance, inflammatory reaction, tissue and cell swelling, electrolyte imbalance, and body resistance decline (Wang et al, 2015; Yi et al, 2020). Our preliminary studies found that several pathophysiological parameter disorders were presented following the seawater immersion combined with hemorrhagic shock (SIHS), such as high incidence of the lethal triad and dysfunction of multiple organs, and electrolyte disturbance, which led to high mortality and brought large challenges to the emergency treatment
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
