[e-drug] Saline Solution (0.9%) versus Ringer's lactate (cont'd)

["M. Haniki Nik M" <haniki@usm.my>]

E-drug: Saline Solution (0.9%) versus Ringer's lactate (cont'd)
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Hi,

This is what I got from my search:
TRAUMATIC SHOCK:
a. A dextran 70 regimen was more effective than Ringer's acetate
solution in the treatment of traumatic shock and preventing
trauma-induced adult respiratory distress syndrome (ARDS) (Modig,
1986). All patients were victims of severe traumatic shock due to
muscular skeletal trauma (major pelvic and long-bone fractures)
sustained in an automobile accident; 5.5 hours represented the
average delay from the time of accident until the initiation of
therapy. To compensate for interstitial fluid loss, 14 patients were
given dextran 70 and Ringer's acetate; the 17 patients in the
control group received amounts of Ringer's acetate equalling 3 to 4
times the total fluid volume of the dextran group. Both groups
received whole blood as required. The intravenous administration of
20 milliliters of dextran 1 preceded the dextran 70 infusion; 500
milliliters of dextran 70 was administered on a daily basis for 7 to 8
days after the initial shock treatment. Controls received 1 to 1.5
liters of Ringer's acetate daily. Shock treatment continued until a
systolic blood pressure of 100 mm Hg was achieved. A stable
hemodynamic status was achieved in the dextran group within a
mean of 110 +/-18 minutes versus 170 +/-40 minutes for
controls. In the control group, 5 of 17 developed ARDS versus none
for those treated with dextran.

2. VOLUME LOADING:
# a. Forty healthy pregnant women at term received Ringer's
acetate or 3% dextran-70 before Caesarean section. Maternal
changes were significant for a transthoracic fluid index with
Ringer's acetate, indicating an increase in water in the lungs. No
difference in the neonate was observed. Colloids (dextran) may be
preferred over crystalloids (Ringer's acetate) due to greater
hemodynamic stability and lack of water accumulation in the lungs
of the mother (Wennberg et al, 1990).

Kind regards,

Haniki

Dr M.Haniki Nik Mohamed (PharmD)
Clinical and Administrative Pharmacy Discipline
School of Pharmaceutical Sciences
Universiti Sains Malaysia
11800 Pulau Pinang
MALAYSIA

Tel: 6-04-657 7888 x 4085 / 2229
Fax: 6-04-657 0017
e-mail: haniki@usm.my
Also, visit www.usm.my

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