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    Comparison of permissive hypotensive resuscitation, low-volume fluid resuscitation, and aggressive fluid resuscitation therapy approaches in an experimental uncontrolled hemorrhagic shock model
    (Turkish Assoc Trauma Emergency Surgery, 2010) Durusu, Murat; Eryilmaz, Mehmet; Ozturk, Gurkan; Mentes, Oner; Ozer, Tahir; Denir, Turgut
    BACKGROUND In this study, we aimed to compare the efficacy of aggressive fluid resuscitation, low-volume fluid resuscitation and permissive hypotensive resuscitation in an experimental uncontrolled hemorrhagic shock model. METHODS Forty-four male Guinea pigs were used in the study in an experimental uncontrolled shock model. Guinea pigs were split into six groups including normovolemic-normotensive fluid treatment group, normovolemic-permissive hypotensive fluid treatment group, low-volume normotensive fluid treatment group, low-volume permissive hypotensive fluid treatment group, no treatment (n=6), and sham-operated groups (n=6). Resuscitation was initiated when mean arterial pressure (MAP) reached 30 mmHg. In the permissive hypotensive resuscitation group, fluid treatment continued until MAP reached 45 +/- 5 mmHg and in the aggressive fluid groups until MAP reached 60 +/- 5 mmHg. Resuscitation fluid was hetastarch 6% (hydroxyethyl starch) in the low-volume fluid groups and Ringer's lactate in the normovolemic fluid groups. RESULTS Mean survival time was 122.75 +/- 4.83 min in the normovolemic-normotensive fluid group, 130.87 +/- 16.31 min in the normovolemic-permissive hypotensive group, 122.12 +/- 11.53 min in the low-volume-normotensive fluid group, and 152.25 +/- 9.10 min in the low-volume-permissive hypotensive fluid group. Survival time was found significantly higher in the group in which low-volume-permissive hypotensive fluid treatment was applied than in the other groups. CONCLUSION When pressure effect was compared during treatment, permissive-hypotensive resuscitation was found more effective in both groups that received colloid and crystalloid treatment.