Advances in shock research
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Commercially available Ringer's lactate solution has a pH of approximately 6.5. In a situation such as shock, which is normally accompanied by a metabolic acidosis, this additional acid load could have an adverse effect on resuscitation when massive amounts of fluid are required. We prepared a similar solution with a pH of 7.4 and compared the two solutions. ⋯ All dogs died within 12 hours of the end of the shock period. Our data indicate that the somewhat acidic pH of standard Ringer's lactate does not adversely affect the adequacy of resuscitation. There is no advantage to using Ringer's lactate with a pH of 7.4.
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Both exogenous glucose and adenosine triphosphate--magnesium chloride (ATP-MgCl2, used separately, have been reported to prolong survival after hemorrhagic shock. The purpose of this study was to determine whether intravenously administered glucose plus ATP-MgCl2 given together during hemorrhagic shock would improve cardiac function and survival. Further, we investigated whether glucose had any real additive effect when used in conjunction with ATP-MgCl2, by using ATP-MgCl2 alone and with equimolar mannitol. ⋯ Mean survival of those which received ATP-MgCl2-mannitol was statistically significantly greater at 200.8 +/- 10.3 minutes than ATP-MgCl2-glucose alone with Ringer's (p less than 0.01). Mean survival was greatest in those which received ATP-MgCl2 alone at 201.2 +/- 9.5 minutes (p less than 0.01), and statistically significantly greater than any other treatment group except ATP-MgCl2-mannitol. ATP-MgCl2 alone significantly increased survival compared to those which received ATP-MgCl2-glucose.