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Cox Alan T.; Ho, Hung S.; Gunther, Robert A.
Shock: May 1994
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A marked diuresis has been observed following resuscitation of hypotensive hemorrhaged animals with small volume hypertonic saline/dextran (HSD), 7.5% NaCl/6% dextran-70. We tested the hypothesis that high arginine vasopressin (AVP) levels associated with severe hemorrhage may exacerbate the diuretic effect of HSD infusion in euvolemic sheep. Following AVP infusion, a significant bradycardia (55% of baseline) and decreased cardiac output (62% of baseline) was observed (p ≤ .05). Urine output increased during AVP infusion (25.4 ± 2.3 ml/20 min) compared to control group (10.5 ± 1.0 ml/20 min) (p ≤ .0001). With HSD volume expansion, urine flow in the AVP group was initially 1.7 times greater than the control group (104.8 ± 10 ml/20 min vs. 60.2 ± 15 ml/20 min) (p ≤ .05). High serum levels of AVP (600 ± 33 pg/ml) may contribute to the diuresis seen with HSD resuscitation and possibly contribute to the bradycardia observed with severe hemorrhage.

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