The change in bone marrow after intraosseous hypertonic saline-hydroxyethyl starch infusion for resuscitation of hemorrhagic shock in dog

Abstract

To observe the change in bone marrow after intraosseous hypertonic saline- hydroxyethyl starch (HSH) in dogs with hemorrhagic shock. Eighteen male dogs were randomly divided into sham group, normal saline (NS) group (0.9% sodium chloride) and HSH group (7.5% sodium chloride-6% hydroxyethyl starch). Wiggers graded controlled hemorrhagic shock model was reproduced in NS and HSH groups, and above solutions were injected into bone marrow of the tibia in low dosage (4 ml/kg) rapidly (within 5 minutes). The sham group did not lose blood or receive infusion. CD34(+) expression of peripheral blood and bone marrow, and the change in picture of different hematopoietic series in bone marrow were examined before and after bone marrow resuscitation. Pathological change in bone marrow was examined after different resuscitation fluid infusion. After 48 hours of resuscitation, the percentage of CD34(+) in bone marrow and peripheral blood in HSH group were significantly higher than that of NS group [peripheral blood: (6.915+/-1.178)% vs. (4.848+/-0.527)%, bone marrow: (7.900+/-0.648)% vs. (6.875+/- 0.403)% , both P<0.05]. One week after resuscitation, the erythrocyte count and granulocytic count in NS group were significantly increased compared with sham group (erythrocyte count: 0.289+/-0.016 vs. 0.253+/-0.014, granulocytic count: 0.615+/-0.019 vs. 0.560+/-0.013, both P<0.05], lymphocytic count was significantly decreased (0.049+/-0.007 vs. 0.132+/-0.015, P<0.05). In the HSH group, erythrocyte count (0.273+/-0.012), lymphocytic count (0.162+/-0.014) were all significantly increased (both P<0.05), while granulocytic count (0.517+/-0.038) was significantly decreased (P<0.05). After 4 week of resuscitation, the change in hemopoiesis series in NS group and HSH group recovered to normal level. The bone marrow morphology changed slightly, and no bone necrosis occurred. HSH in small amount through intraosseous space is safe and effective as a fluid resuscitation measure for shock, and little change in bone marrow has been found after the infusion.