Large volume of low molecular weight dextran, gelatin modified solution, 5 per cent dextrose, lactated ringer and saline as plasma expander or E. C. F replacer have been successfully used to restore hemodynamics after hemorrhage or to prime heart-lung machine. Sporadic reports aave appeared on increased bleeding or abnormal bleeding time associated with administration of large volume of these slutions.
The author discussed here hemodynamics and coagulation studies on measured blood loss from standard incisions in dogs receiving these solutions.
Methods
Dogs weighing from 15 to 18 kilograms were anesthetized intravenously with pentobarbital sodium. Three parallel incisions down to the fascia, 5 cm. long and 1 cm, apart, were made on one flank. The duration of bleeding and the weighed blood loss before spontaneous. arrest in three incisions were determined. After the bleeding from these control incisionss had ceased, the dogs were rapidly bled by amounts of 15 ml. per kilogram femoral artery.
After withdrawal of the blood, the solution to be tested was rapidly infused via the femoral vein. Ten minutes after the infusion was completed, three similar parallel incisions. were made on the opposite flank and the duration of bleeding and weighed blood loss were again measured.
Conclusions were as follows.
1. Hemodynamically, cardiac output and arterial blood pressure increased but totall peripheral resistance decreased in the group of low molecular weight dextran. The similar, but less improvement was observed in the group of gelatin. However, in the other groups. no improvement of hemodynamics were observed.
2. Bleeding from skin incisions increased markedly after administration of low molecular weight dextran. Among these solutions, 5 per cent dextrose caused the least blood loss.
3. On blood coagulation studies, Clotting time, Thrombotest, and P.R.T prolonged in low molecular weight dextran, but in other solutions were almost within normal variations. with the method employed.
4. Alterations in coagulation factors do not appeared to be sufficient to explain the bleeding.
The increased capillary blood flow and deranged blood cagulation were implicated as significant factor in increased bleeding.
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