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Toxic Shock Drug Might Aid Trauma Victims
Date:9/27/2007

to replicate emergency room situations resembling those of human patients who might be cared for after copious bleeding linked to head injury.

At specific doses, norepinephrine combined with standard resuscitation fluids significantly boosted the rats' odds of survival, the French team found.

Poloujadoff said she hopes these results will provide scientific justification to begin clinical research in human on the use of norepinephrine in these scenarios.

The study was published in the October issue of Anesthesiology.

But until more studies are done, the impact of the French results may be limited, said Dr. Philip Levin, chief of anesthesia and director of perioperative services at Santa Monica UCLA Medical Center and Orthopedic Hospital.

"If I read this in one of my journals, it would sound interesting, but I'd wait until we get human studies and larger studies before I'd change my habits," he said.

Another expert agreed.

Dr. Ron M. Walls, a professor of medicine at Harvard Medical School, said that the use of norepinephrine might have some benefit but that, "first we need to know a lot more and have more studies before we could consider this in humans."

Ideas about fluid resuscitation in humans have changed over the last 10 years, he said. Current theory involves the use of fluid to keep vital organs perfused, rather than trying to use enough fluid to restore normal blood pressure, said Walls, who is also chairman of emergency medicine at Brigham and Women's Hospital, in Boston.

"You don't want to constrict the blood vessels more, you want to perfuse the blood," he said.

However, Walls believes the norephinephrine idea might merit further study, especially from the perspective of trying to keep trauma victims alive until they can reach a hospital.

"There's so much blood loss from trauma around the world from both combat and non-combat situations,"
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