The immediate response to severe shock in a canine model with a combination of hypertonic-hyperoncotic solution with naloxone

Shock. 2006 Oct;26(4):379-85. doi: 10.1097/01.shk.0000226339.48033.8b.

Abstract

To evaluate the acute hemodynamic and acid-base balance effects of hypertonic-hyperoncotic solution (HHS) combined with naloxone in the treatment of hemorrhagic shock in 45 male splenectomized adult mongrel dogs, a severe controlled hemorrhagic shock (20 mmHg mean arterial pressure during 30 min) was established in the groups (n=6) no treatment, shed blood reinfusion, hypertonic-hyperoncotic (saline-dextran) solution alone, naloxone alone (NX), or combination. Interventions included propiopromazine-pentobarbital anesthesia and installation of Swan-Ganz, femoral arterial, and urethral catheters, and exsanguination at 20 mmHg mean arterial pressure during 30 min followed by treatment and observation for 160 min. Fifteen (33%) dogs died before completing the 30-min shock period. Another 33% from the no-treatment group died during the following 90 min. Shed blood improved the cardiac index, arterial pressure, and acid-base balance. NX restored the cardiac index to less than 60% of baseline and reduced vascular resistance. Additionally, NX produced no improvement in acidosis, with 1 dog dead at 95 min posttreatment. HHS restored the cardiac index for 45 min and increased vascular resistance and arterial pressure. Acidosis was not improved. Single-dose HHS combined with naloxone resulted in a high cardiac index, oxygen consumption, and urine output with low peripheral vascular resistance (and no acute mortality) compared with untreated or single-dose groups.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Albumins / therapeutic use*
  • Animals
  • Dogs
  • Hypertonic Solutions / therapeutic use
  • Male
  • Naloxone / pharmacology*
  • Narcotic Antagonists / pharmacology*
  • Shock / drug therapy*

Substances

  • Albumins
  • Hypertonic Solutions
  • Narcotic Antagonists
  • hyperoncotic albumin
  • Naloxone