Effect of small-volume resuscitation on intracranial pressure and related cerebral variables.
BACKGROUND
Head injury outcome is adversely affected by the presence of hypotension. Therapies directed at rapidly correcting hypotension may improve outcome.


METHODS
In two separate studies, we investigated small-volume resuscitation (4 mL/kg) using Ringer's lactate, hypertonic saline and dextran, and diaspirin cross-linked hemoglobin in a porcine model of cryogenic brain injury and shock.


RESULTS
Small-volume resuscitation with hypertonic saline and dextran and diaspirin cross-linked hemoglobin significantly improved mean arterial pressure and cerebral perfusion pressure compared with Ringer's lactate. These data suggest that small-volume resuscitation with hypertonic saline and dextran or diaspirin cross-linked hemoglobin may effectively limit or prevent secondary ischemic brain injury after head injury and shock.
Shackford
S R
SR
Department of Surgery, University of Vermont, Burlington 05401, USA.
D000818:Animals; D001241:Aspirin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D003911:Dextrans / Q000627:therapeutic use*; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical; D004359:Drug Therapy, Combination; D005440:Fluid Therapy / Q000379:methods; D006454:Hemoglobins / Q000627:therapeutic use*; D007427:Intracranial Pressure / Q000187:drug effects*; D007552:Isotonic Solutions / Q000627:therapeutic use*; D010952:Plasma Substitutes / Q000627:therapeutic use*; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D012774:Shock, Traumatic / Q000209:etiology*; D013552:Swine
D003911:Dextrans; D006454:Hemoglobins; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic; C053936:hemoglobin XL99alpha; D001241:Aspirin