Limited fluid resuscitation in uncontrolled hemorrhagic shock

Objective: To investigate the effect of limited resuscitation in a model of uncontrolled hemorrhagic shock.Methods: Uncontrolled hemorrhagic shock model was established in 40 rabbits.When mean arterial pressure(MAP) was lowered to 40 mmHg and maintained 30 minutes,resuscitation was begun.Ringer's solution in fusion was continued as needed to maintain the following desired requirements:Group N4 without resuscitation,Group N3 with the most fluid,Group N2 with more fluid,Group N1 with little fluid after shock.Besides,GroupN5 without shock.MAP,the death rate,the blood loss,superoxide dismutase(SOD),the hematocrit(Hct) of all animals were observed for 210 minutes or until death.Results: MAP,death rate,blood loss,SOD,Hct of Group N5 were better than Group N1,N2,N3(P<0.01).MAP,death rate,blood loss and Hct of Group N4 is worse than Group N1,N2,N3(P<0.01).The death rate of Group N4 was the first in all groups.With the increase of fluid in resuscitation,death rate became higher at last and the blood loss became high in resuscitation(P<0.01).Hct and MAP in Group N1 were significantly higher than in Group N2,N3,N4 in the end(P<0.01).SOD of Group N1 was the highest in all groups except Group N5(P<0.01).Conclusions: Attempts to achieve normal MAP during uncontrolled bleeding will result in more hemorrhage volume and markedly higher mortality.Limited resuscitation before hemostat could significantly reduce death rate and blood loss for the following treatment.