Adenosine, Lidocaine and Mg2+ (ALM) fluid therapy for treatment of non-compressible uncontrolled haemorrhage

Systemic inflammation and coagulopathy are major drivers of injury progression following haemorrhagic trauma. Our aim was to examine the effect of small-volume 3% NaCl adenosine, lidocaine and Mg2+ (ALM) bolus and 0.9% NaCl/ALM 'drip' on inflammation and coagulation in a rat model of haemorrhagic shock. Male Sprague-Dawley rats were randomly assisned to: 1) shams, 2) no-treatment, 3) saline controls, 4) ALM therapy, and 5) Hextend. Haemorrhage was induced in anaesthetized and ventilated animals by liver resection (60% left lateral lobe and 50% medial lobe). After 15 min, a bolus of 3% NaCl +/- ALM (0.7 ml/kg) was administered intravenously (Phase 1) followed 60 min later by 4 hours infusion of 0.9% NaCl +/- ALM (0.5 ml/kg/hr) with 60 min monitoring (Phase 2). Plasma cytokines were measured on Magpix and coagulation using Stago/Rotational Thromboelastometry.