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출혈성 쇼크의 인공소생술시 고장식 염용액이 전신혈역학에 미치는 영향
Hemodynamic Effect of Hypertonic Saline in Resuscitation From Hemorrhagic Shock
김재황 ( Jae Hwang Kim ) , 김욱동 ( Wook dong Kim ) , 박동일 ( Dong Ill Park ) , 김홍진 ( Hong Jin Kim ) , 서보양 ( Bo Yang Suh ) , 심민철 ( Min Chul Shim ) , 권굉보 ( Koing Bo Kwun )
UCI I410-ECN-0102-2009-510-004170933

 Recently hypertonic salt solution has been reported to restore normal circulation effectively in hypovolemic shock. It has also advocated to requireless amount of total fluid for resuscitation and to cause less tissue edema than isotonic saline solution.  Author conducted an experiment to compare the effects of hypertonic resuscitation to isotonic resuscitation in a hypovolemic dog model.  Fifteen dogs were divided into 3 groups with 5 dogs each. Hemorrhagic shock were made to all animal by Modified Wiggers method.  Normal saline, 1.5% and 3% NaCl solutions were used for resuscitation in each group, and changes of hemodynamicsand electrolyte were observed. Theresults are as follows ;  MAP(Mean arterial pressure) was increased significantly in group 3(from 63 ±5.3mmHg to 111 ±9.2mmHg) than it was in group 1(from 73 ±1.5mmHg to 102 ±1.3mmHg) ; p<0.05.  Cardiac output change was also significant in group 3 compare to group 1(3.8 ±0.36L/min vs 2.7 ±0.12L/min) ; p<0.05.  Total peripheral resistance was decreased significantly in group 3 than in group 1(2153 ±233dyne sec/cm5 vs 3270 ±814dyne sec/cm) ; p<0.05.  Serum sodium and osmolarity elevated remarkably at the early time after resusiciation in group 3, but these abnornalities were spontaneously corrected by a day.  Urine output was much higher in group 3 than in group 1(134㎖ vs 72㎖k㎖  In Summary㎖ Hypertonic salt solution was more effective restore normal circulation in hemorrhagic shock with less amount of total vloume than isotonic saline solutionℓ  This solution appears promising for the immediate rsuscitation of injured hypovolemic patient clinically

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