Abstract
Hypertonic saline resuscitation was compared to isotonic fluid resuscitation in a large animal model combining hemorrhagic shock with head injury. Sheep were subjected to a freeze injury of one cerebral hemisphere as well as 2 hours of hypotension at a mean arterial pressure (MAP) of 40 mm Hg. Resuscitation was then carried out (MAP = 80 mm Hg) for 1 hour with either lactated Ringer's (LR, n = 6) or 7.5% hypertonic saline (HS, n = 6). Hemodynamic parameters and intracranial pressure (ICP) were followed. At the end of resuscitation brain water content was determined in injured and uninjured hemispheres. No differences were detected in cardiovascular parameters; however, ICPs were lower in animals resuscitated with HS (4.2 ± 1.5 mm Hg) compared to LR (15.2 ± 2.2 mm Hg, p < 0.05). Additionally, brain water content (ml H2O/gm dry weight) in uninjured brain hemispheres was lower after HS resuscitation (HS = 3.3 ± 0.1; LR = 4.0 ± 0.1; p < 0.05). No differences were detected in the injured hemispheres. We conclude that hypertonic saline abolishes increases in ICP seen during resuscitation in a model combining hemorrhagic shock with brain injury by dehydrating areas where the blood-brain barrier is still intact. Hypertonic saline may prove useful in the early management of multiple trauma patients.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 182-188 |
| Number of pages | 7 |
| Journal | Journal of Trauma |
| Volume | 31 |
| Issue number | 2 |
| State | Published - 1991 |
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ASJC Scopus subject areas
- Surgery
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Combined hemorrhagic shock and head injury : Effects of hypertonic saline (7.5%) resuscitation. / Battistella, F. D.; Wisner, David H.
In: Journal of Trauma, Vol. 31, No. 2, 1991, p. 182-188.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Combined hemorrhagic shock and head injury
T2 - Effects of hypertonic saline (7.5%) resuscitation
AU - Battistella, F. D.
AU - Wisner, David H
PY - 1991
Y1 - 1991
N2 - Hypertonic saline resuscitation was compared to isotonic fluid resuscitation in a large animal model combining hemorrhagic shock with head injury. Sheep were subjected to a freeze injury of one cerebral hemisphere as well as 2 hours of hypotension at a mean arterial pressure (MAP) of 40 mm Hg. Resuscitation was then carried out (MAP = 80 mm Hg) for 1 hour with either lactated Ringer's (LR, n = 6) or 7.5% hypertonic saline (HS, n = 6). Hemodynamic parameters and intracranial pressure (ICP) were followed. At the end of resuscitation brain water content was determined in injured and uninjured hemispheres. No differences were detected in cardiovascular parameters; however, ICPs were lower in animals resuscitated with HS (4.2 ± 1.5 mm Hg) compared to LR (15.2 ± 2.2 mm Hg, p < 0.05). Additionally, brain water content (ml H2O/gm dry weight) in uninjured brain hemispheres was lower after HS resuscitation (HS = 3.3 ± 0.1; LR = 4.0 ± 0.1; p < 0.05). No differences were detected in the injured hemispheres. We conclude that hypertonic saline abolishes increases in ICP seen during resuscitation in a model combining hemorrhagic shock with brain injury by dehydrating areas where the blood-brain barrier is still intact. Hypertonic saline may prove useful in the early management of multiple trauma patients.
AB - Hypertonic saline resuscitation was compared to isotonic fluid resuscitation in a large animal model combining hemorrhagic shock with head injury. Sheep were subjected to a freeze injury of one cerebral hemisphere as well as 2 hours of hypotension at a mean arterial pressure (MAP) of 40 mm Hg. Resuscitation was then carried out (MAP = 80 mm Hg) for 1 hour with either lactated Ringer's (LR, n = 6) or 7.5% hypertonic saline (HS, n = 6). Hemodynamic parameters and intracranial pressure (ICP) were followed. At the end of resuscitation brain water content was determined in injured and uninjured hemispheres. No differences were detected in cardiovascular parameters; however, ICPs were lower in animals resuscitated with HS (4.2 ± 1.5 mm Hg) compared to LR (15.2 ± 2.2 mm Hg, p < 0.05). Additionally, brain water content (ml H2O/gm dry weight) in uninjured brain hemispheres was lower after HS resuscitation (HS = 3.3 ± 0.1; LR = 4.0 ± 0.1; p < 0.05). No differences were detected in the injured hemispheres. We conclude that hypertonic saline abolishes increases in ICP seen during resuscitation in a model combining hemorrhagic shock with brain injury by dehydrating areas where the blood-brain barrier is still intact. Hypertonic saline may prove useful in the early management of multiple trauma patients.
UR - http://www.scopus.com/inward/record.url?scp=0025805102&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0025805102&partnerID=8YFLogxK
M3 - Article
C2 - 1994077
AN - SCOPUS:0025805102
VL - 31
SP - 182
EP - 188
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 2
ER -