J Trauma
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Adenosine A2a receptor stimulation can increase coronary perfusion and also reduce leukocyte-mediated inflammatory responses in some conditions. Hextend is a novel colloid solution that may have antioxidant properties. All these actions might be beneficial after severe chest trauma, but have never been investigated. To fill these gaps, this study evaluated the therapeutic potential of a novel adenosine A2a agonist during fluid resuscitation from severe chest trauma with either standard-of-care crystalloid or Hextend. ⋯ Hextend reduced the volume for initial resuscitation, which may offer logistical advantages in prehospital field conditions or whenever there is limited medical resources or prolonged transport times; ATL-146e improved early cardiac performance without causing hypotension or bradycardia; when administered 25 to 30 minutes after injury, neither Hextend nor ATL-146e altered inflammatory changes in pulmonary Mphis or infiltrating PMNs; and further studies are needed to determine whether these short-term benefits correlate with long-term outcome.
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Using a standardized model of uncontrolled hemorrhagic shock induced by massive splenic injury (MSI), we compared bolus infusion of Ringer's lactate (RL) and hypertonic saline (HTS), combined with splenectomy, to continuous infusion of these solutions and splenectomy in rats. ⋯ Continuous infusion of RL combined with splenectomy was followed by significantly less bleeding than bolus infusion of RL and improved survival time compared with untreated animals. Continuous HTS infusion and bolus infusion of HTS with splenectomy resulted in minimal blood loss and improved survival compared with untreated animals. No significant difference in blood loss or survival time was observed between bolus and continuous HTS infusion.