Traumatic shock and head injury: Effects of fluid resuscitation on the brain

David H Wisner, F. Busche, J. Sturm, M. Gaab, H. Meyer

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

The effects of resuscitation of traumatic-hemorrhagic shock on the brain are unknown. Traumatic shock in sheep (fracture/crush injury, 2-hr hemorrhage to 40 mm Hg) was followed by resuscitation to baseline mean arterial pressure. Two groups without brain injury were resuscitated with lactated Ringer's (LR1, n = 7) or albumin (ALB1, n = 6). Focal brain injury was added in two further groups (LR2, n = 6; ALB2, n = 6). Hemodynamics, intracranial pressure (ICP), EEG, and colloid osmotic pressure (COP) were followed. Brain water (BW) and cerebral blood volume (CBV) were compared to those of controls (C, n = 7). Results: ICP rose in all groups. Animals without brain injury did not have increased brain water. Below are results for brain-injured animals after resuscitation (mean ± SEM). {A table is presented} Maintaining COP during initial resuscitation does not minimize cerebral edema: the effects of LR and ALB were similar in this setting. Focal brain injury causes edema but does not cause large increases in ICP with initial resuscitation.

Original languageEnglish (US)
Pages (from-to)49-59
Number of pages11
JournalJournal of Surgical Research
Volume46
Issue number1
DOIs
StatePublished - 1989

ASJC Scopus subject areas

  • Surgery

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