| Abstract: |
(1)from this study, it was found that the use of (acetated ringer’s solution) which is better than (Lactated ringer’s solution) in cases of hemorrhagic shock as regards the following;More rapid improvement of the trend towards normalization of the proposed endpoints of resuscitation in the values of (base deficit and o2 extraction ratio) in (acetated ringer’s solution) when compared to (Lactated ringer’s solution).Also, Significant difference in % of change from admission to 24hours values as regard, (Arterial Lactate, Base Deficit and oxygen extraction ratio) in favor of G2 (acetated ringer’s) over G1 (lactated ringer’s).N0 significant difference in the % of changes after 24 hours between G1 (LR) and G2 (AR) as regard (MAP, HCO3, Ph and Hb) Also N0 significant difference in the cost between both groups.(2) from this study, it was found also that the use of HES (Voluven) is better than Gelatin (Haemagel) on hemorrhagic shock as regards the following;More rapid improvement of the trend towards normalization of the proposed endpoints of resuscitation in the values of (base deficit, arterial lactate and o2 extraction ratio) in G3 HES (Voluven) treated patients started earlier at 2hours reading; Meanwhile in G4 Gelatin (Haemagel) significant changes for the same parameters started later at the 4hour readings.We found that, significant difference in the % of change as regards (MAP, Arterial Lactate&Base Deficit) Between G3& G4 in favor of (G3) HES (Voluven) over (G4) Gelatin (Haemagel), Meanwhile N0 significant difference between G3 (voluven) and G4 (Haemagel) in the %changes of (HCO3, Ph, o2 extraction ratio and Hb) after 24 hoursAlso there was a significant difference in the cost between both groups as G3 more expensive than G4.(3) There was significant change before and after blood transfusion in the following parameters (MAP, HR, CVP, Hb, O2 extraction, Arterial o2 tension, Base Deficit and Arterial Lactate).Meanwhile, the highest cost, rarity of donors and the biological hazard of blood transfusion urge us to optimize the use of blood according to the clinical condition of the patient, such as (ongoing uncontrollable blood loss)(4) Serial estimation of base deficits and arterial lactate, which are easily available investigation, is useful in judging the tissue perfusion during resuscitation of patients in hemorrhagic shock.(5) Further researches are needed for evaluation of the ScvO2 as asurrogate measure of mixed venous O2 saturation because itobviates the cost and morbidity associated with pulmonaryartery catheters.
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