Resuscitation of Hypothermic-Hypovolemic-Hypotensive Baboons.

Abstract : Because baboon hemodynamics, lung function, oxygen transport function, clotting proteins, and platelet function are similar to those of man, we made a study of hypothermic, hypovolemic, hypotensive baboons to evaluate treatment programs. When the temperature of the animal was reduced from 37 C to 32 C, a prolonged bleeding time was observed without thrombocytopenia. When the cold extremity was warmed, the prolonged bleeding time was corrected. These observations support the recommendation that warming a lacerated hypothermic extremity will reduce blood loss. When the hypothermic, hypovolemic, hypotensive baboon was treated with previously frozen washed red cells and citrated fresh frozen plasma, we observed electromechanical dissociation of the heart and subsequent treatment with calcium chloride corrected this disorder. There was no increase in total oxygen consumption, limb oxygen consumption, or cardiac output associated with the exchange transfusion and resuscitation with red blood cells with 125 percent of normal 2,3 DPG levels compared to red cells with 40 percent of normal 2,3 DPG levels. The infusion of red cells with 125 percent of normal 2,3 DPG did produce significantly elevated 2,3 DPG levels, elevated in vitro and in vivo P50 values, and elevated mixed venous p02 tensions, compared to the infusion of red cells with 40 percent of normal 2,3 DPG.