Hemodynamic Variables and Tissue Energetics during Resuscitation of Porcine Hemorrhagic Shock with Hextend or Lactated Ringer’s Solution

There has been recent interest in resuscitation of hemorrhagic shock using new colloid solutions such as Hextend (6% hydroxyethyl starch in balanced salt solution). We examined the effects of resuscitation of porcine hemorrhagic shock with Hextend or lactated Ringer’s (LR) solution on hemodynamic parameters and tissue energetics. Anesthetized, instrumented pigs underwent hemorrhagic shock (35% total blood volume, 90 minutes) and were randomized to resuscitation with Hextend 10 cc/kg (n=5), Hextend 20 cc/kg (n=8), or LR 20 cc/kg (n=10) per step in four steps. Endpoints measured included invasive hemodynamics, near infrared (NIR) spectroscopic measures of tissue hemoglobin saturation (StO2) in stomach, liver, and hind limb, and in vivo nuclear magnetic resonance (NMR) measures of tissue phosphoenergetics of liver and hind