Initial small-volume hypertonic resuscitation of shock and brain injury: Short- and long-term effects

John T Anderson, David H Wisner, Patrick E. Sullivan, Michael Matteucci, Steven Freshman, Jana Hildreth, Frank C. Wagner

Research output: Contribution to journalArticlepeer-review

42 Scopus citations

Abstract

Background: Initial small-volume hypertonic saline resuscitation of a combined hemorrhagic shock and head injury model was studied. Methods: Twenty-three sheep underwent hemorrhage (20 mL/kg) and parietal freeze injury followed by initial bolus resuscitation with lactated Ringer's solution (40 mL/kg) or 7.5% hypertonic saline (HS) (4 mL/kg). Cardiac index was maintained with lactated Ringer's solution for either 2 or 24 hours. Parietal lobe water content, blood volume, and blood flow were determined. Intracranial pressure (millimeters of mercury) was followed. Results: Overall fluid requirements (milliliters per kilogram) were less at 2 and 24 hours with HS resuscitation. Early intracranial pressure was less with HS resuscitation. Brain water contents were similar between groups. Blood flow in injured and blood volume in uninjured parietal lobe were less for HS at 2 hours, although not different at 24 hours. Conclusions: Less fluid was needed in the short- and long-term with HS resuscitation. Early intracranial pressure was higher with lactated Ringer's solution resuscitation, possibly in part owing to increased blood volume.

Original languageEnglish (US)
Pages (from-to)592-601
Number of pages10
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume42
Issue number4
StatePublished - Apr 1997

Keywords

  • Cerebral blood flow
  • Cerebral blood volume
  • Head injury
  • Hemorrhagic shock
  • Hypertonic saline
  • Intracranial pressure

ASJC Scopus subject areas

  • Surgery

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