| Abstract: | The purpose of this study was to determine whether Ringer's lactate solution increases extravascular lung water (EVLW) during resuscitation after hemorrhagic shock. Ten sheep anesthetized with thiamylal were bled to a mean arterial pressure (MAP) of 50 mm Hg; further bleeding maintained that pressure for 30 min. Resuscitation fluid consisted of Ringer's lactate solution in volumes necessary to restore and maintain for 1 hr MAP, pulmonary capillary wedge pressure (PCWP), and cardiac index at levels equal to those measured before bleeding. After volume replacement, the colloid oncotic pressure (COP) - PCWP gradient (COP - PCWP) decreased from 12 +/- 3 to 2 +/- 5 mm Hg (P less than 0.001). After volume restoration, COP decreased from 19 +/- 8 mm Hg to 12 +/- 2 mm Hg (P less than 0.001). Despite the large volume of fluid administered, EVLW did not increase. Crystalloid resuscitation does not necessarily increase EVLW despite significant decreases in COP and COP - PCWP gradient. |
