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Norepinephrine May Improve Survival in Hemorrhagic Shock

Animal study suggests trauma patients may benefit from early-phase norepinephrine infusion

WEDNESDAY, Sept. 26 (HealthDay News) -- In the treatment of trauma victims with uncontrolled bleeding and shock, early-phase fluid resuscitation plus norepinephrine may offer a new strategy for improving the odds of survival, according to the results of an animal study published in the October issue of Anesthesiology.

Frederic Adnet, M.D., Ph.D., of Avicenne Hospital in Bobigny, France, and colleagues subjected anesthetized rats to a 15-minute controlled hemorrhage and a 60-minute uncontrolled hemorrhage and studied the effects of different doses of norepinephrine in four hypotensive resuscitation groups and four normotensive resuscitation groups.

The researchers found that a moderate dose of norepinephrine was associated with the highest survival rates in the hypotensive rats (90 percent) and the normotensive rats (100 percent), and helped reduce the amount of fluid infusion and bleeding volumes. The investigators also found that none of the rats in either group survived the highest dose of norepinephrine.

Current guidelines recommend that hemorrhagic shock patients receive norepinephrine only when they don't respond to initial fluid resuscitation. "Our results on the use of norepinephrine in uncontrolled hemorrhagic shock in rats fully support experimental studies showing that aggressive fluid resuscitation without vasopressors can worsen bleeding by probably impairing the formation of new blood clots or dislodging existing ones," the authors write.

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