Critical care medicine
-
Critical care medicine · Sep 1988
Comparative StudyRewarming from experimental hypothermia: comparison of heated aerosol inhalation, peritoneal lavage, and pleural lavage.
This study compares the thermal transfer and rewarming characteristics of heated aerosol inhalation (HAI) alone and combined with peritoneal lavage (PEL) or pleural lavage (PLL). Closed-system PEL and PLL are equally efficient at rewarming hypothermic dogs and do so at a rate approximating 6 degrees C/h/m2. Cardiovascular responses to PEL and PLL were similar. ⋯ HAI alone provides little heat for rewarming; more heat is realized from endogenous metabolism. Nevertheless, HAI's ease of use and possible selective cardiac rewarming characteristics argue for its inclusion with other methods of active rewarming. The use of PEL or PLL is governed by clinical circumstances.
-
We studied the use of sodium bicarbonate administration in a canine model of hemorrhagic shock to determine its effect on hemodynamics, arterial and venous blood gases, respiratory gases, and blood lactate levels. Thirteen dogs were anesthetized, paralyzed, mechanically ventilated, and hemodynamically monitored. Hypotension was induced and maintained at a mean arterial pressure of 40 to 45 mm Hg using controlled hemorrhage and reinfusion. ⋯ These included heart rate, BP, cardiac output, arterial and venous pH, CO2 production, and bicarbonate levels. Blood lactate levels, however, in the bicarbonate treated animals were significantly (p less than .01) higher than in the group treated with NaCl alone (10.1 +/- 3.2 vs. 5.1 +/- 1.2 mEq/L). These results are similar to the effects of bicarbonate found in other models of lactic acidosis, and suggest that bicarbonate therapy may have limited usefulness in the treatment of lactic acidosis.