title: Hypertonic/hyperoncotic saline attenuates microcirculatory disturbances after traumatic brain injury.
abstract: BACKGROUND
  Traumatic brain injury (TBI) induces an acute inflammatory response characterized by early recruitment of inflammatory cells (white blood cells). Rapid resuscitation of TBI with hypertonic saline/dextran (HS/DEX) yields promising results in clinical and experimental studies. The purpose of this paper was to test the hypothesis that HS/DEX exerts its effects in part through a modulation of the acute inflammatory response to TBI.
  
  
  METHODS
  Rabbits equipped with chronic cranial windows underwent fluid-percussion injury and were followed up for 6 hours. Intravital fluorescence videomicroscopy technique was used to visualize white blood cell trafficking and to measure pia vessel diameters and venular shear rates. Three groups were studied: sham (group I, n = 5), trauma (group II, n = 7), and trauma and 4 mL/kg 7.2% NaCl/10% dextran 60 IV over 5 minutes at 10 minutes after TBI (group III, n = 7).
  
  
  RESULTS
  TBI in groups II and III led to significant increases of intracranial pressure. Arteriolar diameters after trauma increased by 17 +/- 8% at 6 hours in group II. Infusion of HS/DEX completely prevented this secondary diameters increase. At 6 hours, the increase of "sticking" white blood cells in group III was reduced by approximately 90% compared with group II.
  
  
  CONCLUSIONS
  Whether the anti-inflammatory effect of HS/DEX plays a role in reducing delayed brain damage (> 6 hours after TBI) or other systemic complications of TBI arises as an important question and should be investigated further.
authors.affiliation: Aitken Neuroscience Institute, New York, NY 10021, USA.
authors.forename: R
authors.initials: R
authors.lastname: Härtl
authors.forename: M B
authors.initials: MB
authors.lastname: Medary
authors.forename: M
authors.initials: M
authors.lastname: Ruge
authors.forename: K E
authors.initials: KE
authors.lastname: Arfors
authors.forename: F
authors.initials: F
authors.lastname: Ghahremani
authors.forename: J
authors.initials: J
authors.lastname: Ghajar
mesh_terms: D000208:Acute Disease; D000818:Animals; D001930:Brain Injuries / Q000276:immunology / Q000503:physiopathology* / Q000628:therapy*; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D002675:Child, Preschool; D003911:Dextrans / Q000627:therapeutic use*; D004195:Disease Models, Animal; D004338:Drug Combinations; D004353:Drug Evaluation, Preclinical; D006801:Humans; D007249:Inflammation; D007962:Leukocytes / Q000276:immunology; D008833:Microcirculation / Q000187:drug effects*; D010952:Plasma Substitutes / Q000627:therapeutic use*; D011817:Rabbits; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D003911:Dextrans; D004338:Drug Combinations; D010952:Plasma Substitutes; D012462:Saline Solution, Hypertonic