"Small volume resuscitation" as treatment of cerebral blood flow disturbances and increased ICP in trauma and ischemia.
"Small volume resuscitation" (SVR) is a promising concept for the treatment of shock and trauma patients. SVR utilizes the fast infusion of a small volume of hypertonic saline to mobilize intraendothelial and parenchymal water to expand and restitute intravascular volume. Therefore it seems warranted to also consider SVR for the treatment of disturbances of the cerebral circulation and of increased intracranial pressure (ICP). The current study uses a rabbit model of global cerebral ischemia combined with mild hemorrhage to test SVR. Somatosensory evoked potentials (SEPs) serve as a short-term outcome parameter. The data demonstrate a beneficial effect treatment with hypertonic/hyperoncotic saline/hydroxyethylstarch as compared to volume replacement with starch or blood.
Kempski
O
O
Institute for Neurosurgical Pathophysiology, Johannes Gutenberg-Universität Mainz, Federal Republic of Germany.
Obert
C
C
Mainka
T
T
Heimann
A
A
Strecker
U
U
D000818:Animals; D001783:Blood Flow Velocity / Q000502:physiology; D001804:Blood Transfusion, Autologous; D001810:Blood Volume / Q000502:physiology*; D001812:Blood-Brain Barrier / Q000502:physiology; D001921:Brain / Q000098:blood supply*; D001930:Brain Injuries / Q000503:physiopathology*; D002545:Brain Ischemia / Q000503:physiopathology*; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D005440:Fluid Therapy; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage; D007427:Intracranial Pressure / Q000502:physiology*; D011817:Rabbits; D012151:Resuscitation; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage; D014882:Water-Electrolyte Balance / Q000502:physiology
D006895:Hydroxyethyl Starch Derivatives; D012462:Saline Solution, Hypertonic