Effects of crystalloid-colloid solutions on traumatic brain injury.
The purpose of this study was to compare the effects of crystalloid and crystalloid-colloid solutions administered at different times after isolated traumatic brain injury. Male Sprague-Dawley rats were randomized to receive one of three intravenous treatments (4 mL/kg body weight) at 10 min or 6 h after moderate traumatic brain injury. Treatments included hypertonic saline, hypertonic albumin, and normal albumin. Moderate injuries were produced using the controlled cortical impact injury model set at 2.0 mm, 4.0 m/sec, and 130 msec. Tissue damage and cerebral edema were measured to evaluate the effect of treatments for traumatic brain injury. Blood brain barrier permeability was assessed at different time points after injury to identify a mechanism for treatment effectiveness. Injury volume was the smallest for animals treated with hypertonic albumin at 6 h after injury compared to all other treatments and administration times. Ipsilateral brain water content was significantly attenuated with immediate normal saline-albumin treatment. The presence of colloid in the infusion solutions was associated with an improvement in tissue damage and edema following isolated head injury while hypertonic saline alone, when given immediately after injury, worsened tissue damage and edema. When hypertonic saline was administered at 6 h after injury, tissue damage and edema were not worsened. In conclusion, the presence of colloid in solutions used to treat traumatic brain injury and the timing of treatment have a significant impact on tissue damage and edema.
Elliott
Melanie B
MB
Department of Physiology, School of Medicine, Temple University, Philadelphia, Pennsylvania, USA. melaniedion@comcast.net
Jallo
Jack J
JJ
Gaughan
John P
JP
Tuma
Ronald F
RF
D000758:Anesthesia; D000818:Animals; D001812:Blood-Brain Barrier; D001834:Body Water / Q000378:metabolism; D001921:Brain / Q000473:pathology; D001923:Brain Chemistry / Q000502:physiology; D001929:Brain Edema / Q000473:pathology; D001930:Brain Injuries / Q000473:pathology / Q000628:therapy*; D003102:Colloids / Q000627:therapeutic use*; D004396:Coloring Agents; D000077324:Crystalloid Solutions; D005070:Evans Blue; D006982:Hypertonic Solutions / Q000627:therapeutic use; D007552:Isotonic Solutions / Q000627:therapeutic use*; D008297:Male; D010539:Permeability; D051381:Rats; D017207:Rats, Sprague-Dawley
D003102:Colloids; D004396:Coloring Agents; D000077324:Crystalloid Solutions; D006982:Hypertonic Solutions; D007552:Isotonic Solutions; D005070:Evans Blue