Volume Kinetics Of Acetate Ringer’s Solution And Hydroxyethyl Starch(130/0.4) Electrolyte Solution In The Early Fluid Resuscitation On Pig With Hemorrhagic Shock Of Environmental Hypothermia

Objective: To study the Volume kinetics of acetate ringer’s solution and hydroxyethyl starch(130/0.4) electrolyte solution in the early fluid resuscitation on pig with hemorrhagic shock of environmental hypothermiaMethods: Twenty-four Obama mini pigs were divided into four groups randomly. The group of only received acetate ringer’s solution(CN), the group of after shock received acetate ringer’s solution(CX), the group of only received hydroxyethyl starch(130/0.4) electrolyte solution(QN), and the group of after shock received hydroxyethyl starch(130/0.4) electrolyte solution(QX), Each group of pigs were anesthetized with propofol and sevoflurane under mechanical ventilation.Right internal jugular vein and right femoral artery were cut opened and pulmonary artery flotation catheter and venous catheter inserted respectively for hemodynamics and core temperature monitoring and for blooding or blood sampling. Pigs in each group were placed in a special cage 2h for awake and stable. Each group of pigs were placed in-15℃ environment.Group CN only received acetate ringer’s solution with 30 ml/kg infusion through central venous; Group QN only received hydroxyethyl starch(130/0.4) electrolyte solution with 10 ml/kg infusion through central venous. Group CX and QX was adopted to establish the model of uncontrolled hemorrhagic shock(HS) with capacity control method firstly, Group CX received acetate ringer’s solution with 30 ml/kg infusion through central venous and QX received hydroxyethyl starch(130/0.4) electrolyte solution with 10 ml/kg infusion through central venous. Aarterial blood was collected for blood gas analysis every5 min in each group during the fluid infusion until the 90 min infusion finished. Hct and Hb were recorded at the same time. The law of conservation was used for mass analysis of plasma capacity、peripheral blood volume, the capacity of the dilution rate and volume expansion efficiency. Matlab7.5 software was used for fitting out the time- dilution curve of single fluid space model and two fluid space model, which contributed to kinetic parameters, that is one chamber model equation for target volume(V) and clearance(Kr), and two chamber model equation for epicenter ventricular target capacity(V1), peripheral target capacity(V2), clearance(Kr) and the transfer coefficient(Kt) capacityResult:1. Plasma capacity of Group CX and QX was obviously lower than that of control group(p<0.05) at the end of the infusion from 50 min to 90 min. Plasma volume of group QN was obviously higher than that of group CN, group QX obviously higher than that of group CX(p<0.05).2. During the period from infusion finished to 90 min after infusion, the expansion effect of group CX and group QX was higher than that of control group(p<0.05). Volume expansion efficiency of Group QN and QX was greater than that of group CN and CX(p<0.05) significantly.3.During the period from 50 min infusion finished to 90 min after infusion,the peripheral blood volume of group CX and QX was higher than that of control group(p<0.05), and group CX increased significantly, group CN and CX was obviously higher than that of QN and QX(p<0.05).4. IN VOFS1 parameters analysis, comparing to group CN, V and Kr of group CX was decreased significantly(p<0.05). Comparing to group QN, Kr decreased while V remain stable of group QX.Comparing to group CN and CX, Kr was lower significantly in group QN and QX(p<0.05).5. IN VOFS2 parameters analysis, comparing to group CN, V1 and Kr of group CX was decresed significantaly, while V2 and Kt increased(p<0.05). Kr of group CX decreased significantaly. Kt and Kr of group QN and QX was smaller than that of group CN and CX(p<0.05).6.Comparing to plasma capacity measured by ICG, there were statistical difference of VOFS1(V) and VOFS2(V1 + V2) in group CN, QN and CX(p<0.05). Comparing to VOFS1(V), VOFS2(V1 + V2) increased significantly(p<0.05) in group CN and CX.Conclusion:1.Acetate ringer’s solution in pigs early fluid resuscitation of environmental hypothermia is fit for VOFS2. Its target volume decreased,the extravascular volume increased, the metabolism slowed and the plasma volume unsteadiness.2.Hydroxyethyl starch(130/0.4) electrolyte solution in pigs early fluid resuscitation of environmental hypothermia is fitfor VOFS1, Its relocation of vascular was not obvious, the metabolism slowed and the plasma volume was stable.3.The volume expansion efficiency increased significantly with acetate ringer’s solution than that of hydroxyethyl starch(130/0.4) electrolyte solution in pigs with hemorrhagic shock early fluid resuscitation of environmental hypothermia.