Combined hemorrhagic shock and head injury: Effects of hypertonic saline (7.5%) resuscitation

F. D. Battistella, David H Wisner

Research output: Contribution to journalArticle

65 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)182-188
Number of pages7
JournalJournal of Trauma
Volume31
Issue number2
StatePublished - 1991

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Hemorrhagic Shock
Craniocerebral Trauma
Resuscitation
HS 6
Arterial Pressure
Brain
Intracranial Hypertension
Water
Multiple Trauma
Intracranial Pressure
Cerebrum
Blood-Brain Barrier
Hypotension
Brain Injuries
Sheep
Animal Models
Hemodynamics
Weights and Measures
Wounds and Injuries

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 journalArticle

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