Purpose of the Study:
Small volume resuscitation with hypertonic saline (NaCl 7.5%) has been regarded as an efficient and effective method for restoring intravascular volume in cases of acute intraoperative haemorrhage.
The purpose of our study was to present the role of NaCl 7.5% infusion in the management of acute hypovolemia.
Materials and Methods:
Four patients (♂/♀: 1/3), aged 51, 52, 50 and 58 years old, who underwent general surgery procedures, suffered acute major blood loss intraoperatively. For the management of acute hypolovemia, 4ml/kg NaCl 7.5% were administered in each patient at the fastest possible rate through the existing intravenous line. Infusion was completed in 5min, 4.2min, 6min and 5.3min respectively. Thereafter, all patients received Lactated Ringers, vasoactive drugs and packed red blood cells (pRBCs). Heart rate (HR), mean arterial pressure (BPmean), stroke volume (SV), peak velocity (PV), mean acceleration (MA) and corrected flow time (FTc) were recorded before blood loss (Phase 1), before and after completion of NaCl 7.5% administration (Phases 2 & 3), 10min and 20min after NaCl 7.5% administration (Phases 4 and 5) and at the end of the surgical procedure (Phase 6).
Results:
Alterations of recorded parameters are depicted on Graphs 1 and 2. Lowest Hb values were 7.6g/dL, 4g/dL, 5g/dL and 6.6g/dL and the corresponding patients received 3, 5, 4 and 3 units pRBCs respectively. Bleeding was surgically controlled and the surgical procedure was carried out thereafter uneventfully. Vasoactive drugs were discontinued before the end of the surgery.
Conclusions:
NaCl 7.5% can be administered to treat hemodynamic instability with safety provided that bleeding can be managed surgically.
References:
1. Velasco I. Hyperosmotic NaCl and severe hemorrhagic shock. Am J Physio1980; 239; 664-673
2. Kramer G et al. Hyperosmotic-hyperoncotic solutions. BailIiere's Clinical Anaesthesiology 1997; 11: 143-161

HYPERTONIC SALINE RESUSCITATION IN ACUTE INTRAOPERATIVE HAEMORRHAGE: CASE SERIES PRESENTATION

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