The effect of an external counterpressure device (ECPD) on hypertonic saline treatment of uncontrolled hemorrhagic shock (UCHS) was studied in rats. The rats were divided into five groups. In group 1 (n = 11) UCHS induced by incision of three radicals of the ileocolic artery was treated by 5 mL/kg NaCl 0.9% (normal saline). In group 2 (n = 20), UCHS was treated by 5 mL/kg NaCl 7.5% (hypertonic saline). In group 3 (n = 6), UCHS was treated by inflation of ECPD to 50 torr. In group 4 (n = 7), UCHS was treated by ECPD and normal saline; in group 5 (n = 9), UCHS was treated by ECPD and hypertonic saline. Incision of the ileocolic artery in group 1 rats led to a fall in mean arterial pressure to 33 torr (P less than .001) followed by a spontaneous rise to 48 torr (P less than .01) with a mortality rate of 27% and a mean survival time of 161 +/- 9 minutes. Infusion of hypertonic saline during UCHS was followed by a further fall in mean arterial pressure to 18.5 torr (P less than .001); mortality was 80% within 80 minutes with a mean survival time of 35.5 minutes, which was significantly lower than in group 1 (P less than .01). Inflation of ECPD during UCHS in group 3 or treatment with ECPD and normal saline in group 4 did not alter the hemodynamic response and mortality, which were similar to those of group 1.(ABSTRACT TRUNCATED AT 250 WORDS)