title: Identification of ideal resuscitation pressure with concurrent traumatic brain injury in a rat model of hemorrhagic shock.
abstract: BACKGROUND
  Traumatic brain injury (TBI) is often associated with uncontrolled hemorrhagic shock (UHS), which contributes significantly to the mortality of severe trauma. Studies have demonstrated that permissive hypotension resuscitation improves the survival for uncontrolled hemorrhage. What the ideal target mean arterial pressure (MAP) is for TBI with UHS remains unclear.
  
  
  METHODS
  With the rat model of TBI in combination with UHS, we investigated the effects of a series of target resuscitation pressures (MAP from 50-90 mm Hg) on animal survival, brain perfusion, and organ function before hemorrhage controlled.
  
  
  RESULTS
  Rats in 50-, 60-, and 70-mm Hg target MAP groups had less blood loss and less fluid requirement, a better vital organ including mitochondrial function and better cerebral blood flow, and animal survival (8, 6, and 7 of 10, respectively) than 80- and 90-mm Hg groups. The 70-mm Hg group had a better cerebral blood flow and cerebral mitochondrial function than in 50- and 60-mm Hg groups. In contrast, 80- and 90-mm Hg groups resulted in an excessive hemodilution, a decreased blood flow, an increased brain water content, and more severe cerebral edema.
  
  
  CONCLUSIONS
  A 50-mm Hg target MAP is not suitable for the resuscitation of TBI combined with UHS. A 70 mm Hg of MAP is the ideal target resuscitation pressure for this trauma, which can keep sufficient perfusion to the brain and keep good organ function including cerebral mitochondrial function.
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P. R. China; Department of Anesthesiology, Daping Hospital, Third Military Medical University, Chongqing, P. R. China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Hu
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P. R. China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Wu
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P. R. China.
authors.forename: Kunlun
authors.initials: K
authors.lastname: Tian
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P. R. China.
authors.forename: Dan
authors.initials: D
authors.lastname: Lan
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P. R. China.
authors.forename: Xiangyun
authors.initials: X
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P. R. China.
authors.forename: Mingying
authors.initials: M
authors.lastname: Xue
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P. R. China.
authors.forename: Liangming
authors.initials: L
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, P. R. China. Electronic address: lt200132@163.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Li
mesh_terms: D000818:Animals; D001794:Blood Pressure; D001921:Brain / Q000378:metabolism; D001930:Brain Injuries / Q000150:complications*; D002560:Cerebrovascular Circulation; D005260:Female; D006400:Hematocrit; D007677:Kidney Function Tests; D008102:Liver Circulation; D008111:Liver Function Tests; D008297:Male; D008928:Mitochondria / Q000378:metabolism; D010100:Oxygen / Q000097:blood; D011897:Random Allocation; D017207:Rats, Sprague-Dawley; D012079:Renal Circulation; D012151:Resuscitation / Q000379:methods*; D012771:Shock, Hemorrhagic / Q000150:complications / Q000628:therapy*; D014867:Water / Q000378:metabolism
chemical_list: D014867:Water; D010100:Oxygen
keywords: Hemorrhagic shock; Ideal blood pressure; Rats; Resuscitation; Traumatic brain injury