The Effect of Adrenalin Administration on Circulation Stability in Massive Hemorrhage during Operations

Although occurance of sudden and extensive hemorrhage is not a new subject, however due to high morbidity and mortality a high level of experience and expertise is required to control the situation.Single adrenaline injction that is fast and very potent has been used in order to maintain BP and help the use of blood saved in other parts of the body.Durring ۱۳۷۵ to ۱۳۸۱ a total of ۸ patients were confronted with extensive and sudden hemorrhage during heart surgery. All of them experienced sudden arrest or a sharp decrease in blood pressure. Six cases had rupture of the descending aorta of which three had surgery due to coarcetation of the aorta and three had PDA. In these patients one case had extensive cardiac rupture due to cutting of sternum and adhision and one with aortic aneurysm in upperabodmen. In this study, in coordination with the attending surgeon, the place of the rupture was first clamped and the patient was placed in trendelenburg position. Then adrenaline was injected (an average of ۱۷ injections). At the same time other methods were used for the survival of the patient.Twenty minuts later the clamp had set in partial.Blood pressure was maintained at a minimun level during hemorrhage and HR and BP were recorded. None of the patients in this study had morbidity or mortality related to the hemorrhage, although one of the patients deceased later on due to the repeated hemorrhage.Therefore this method is presented as a way of controlling sudden and extensive hemorrhages.

Keywords:

Adrenalin , Hemorrhagic shock , Cardiovascular collapse , Clamp of aorta , Ventilator-close heart operation