Hyperviscous fluids: Better treatment for severe ...( Intravenous administration of isoton...)

Intravenous administration of isotonic fluids is the standard emergency treatment in the U.S. for patients with severe blood loss, but UC San Diego bioengineering researchers have reported improved resuscitation with a radically different approach. Building on earlier studies in humans that have shown benefits of intravenous fluids that are eight times saltier than normal saline, the researchers combined hypertonic saline with viscosity enhancers that thicken blood.

Reporting in the journal Resuscitation in an article that is available online, the researchers describe dramatic increases in beneficial blood flows in the small blood vessels of hamsters with the combined hypertonic saline and viscosity enhancement approach. The fluid was given to animals after as much as half of their blood was removed to simulate human blood losses on the battlefield, in traffic accidents and in operating rooms.

The team led by Marcos Intaglietta, a professor of bioengineering at the Jacobs School of Engineering, reported that the new approach sharply improved the animals functional capillary density, a key measure of healthy blood flow through tissues and organs.

Of course, trauma physicians want to get the blood flowing as soon as possible, and increasing the viscosity of blood may not make any sense to them, said Intaglietta. However, our results are highly suggestive that increasing viscosity rather and partially restoring blood volume is a better way to increase blood flow through tissues. These findings also are consistent with recent discoveries showing that higher shear forces of more viscous blood leads to dilation of small blood vessels.

Treating blood loss is a critical medical issue because trauma is the leading cause of death among North Americans 1 to 44 years old. Whether injured on the freeway or wounded in battlefield, loss of 40 percent or more of a patients blood is immediately life-threatening. Physicians and emergenc
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