title: Effect of volume replacement during combined experimental hemorrhagic shock and traumatic brain injury in prostanoids, brain pathology and pupil status.
abstract: Traumatic brain injury (TBI) is the main cause of trauma-related deaths. Systemic hypotension and intracranial hypertension causes cerebral ischemia by altering metabolism of prostanoids. We describe prostanoid, pupilar and pathological response during resuscitation with hypertonic saline solution (HSS) in TBI. Method Fifteen dogs were randomized in three groups according to resuscitation after TBI (control group; lactated Ringer's (LR) group and HSS group), with measurement of thromboxane, prostaglandin, macroscopic and microscopic pathological evaluation and pupil evaluation.Result Concentration of prostaglandin is greater in the cerebral venous blood than in plasma and the opposite happens with concentration of thromboxane. Pathology revealed edema in groups with the exception of group treated with HSS.Discussion and conclusion There is a balance between the concentrations of prostaglandin and thromboxane. HSS prevented the formation of cerebral edema macroscopically detectable. Pupillary reversal occurred earlier in HSS group than in LR group.
authors.affiliation: Instituto de Psiquiatria, Hospital das Clínicas, Universidade de São Paulo, Sao Paulo, SP, Brazil.
authors.forename: Fernando Campos Gomes
authors.initials: FC
authors.lastname: Pinto
authors.affiliation: Departamento de Neurocirurgia, IAMSPE, Hospital do Servidor Público Estadual de São Paulo, Sao Paulo, SP, Brasil.
authors.forename: Matheus Fernandes de
authors.initials: MF
authors.lastname: Oliveira
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Prist
authors.affiliation: Departamento de Fisiologia, Universidade de São Paulo, Sao Paulo, SP, Brazil.
authors.forename: Maurício Rocha E
authors.initials: MR
authors.lastname: Silva
authors.affiliation: Departamento de Patologia, Universidade de São Paulo, Sao Paulo, SP, Brazil.
authors.forename: Luiz Fernando Ferraz da
authors.initials: LF
authors.lastname: Silva
authors.affiliation: Unidade de Terapia Intensiva, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil.
authors.forename: Antonio
authors.initials: A
authors.lastname: Capone Neto
mesh_terms: D000818:Animals; D001921:Brain / Q000378:metabolism / Q000473:pathology; D001929:Brain Edema / Q000517:prevention & control; D001930:Brain Injuries / Q000188:drug therapy* / Q000378:metabolism; D002560:Cerebrovascular Circulation / Q000502:physiology; D004285:Dogs; D005440:Fluid Therapy / Q000379:methods*; D006439:Hemodynamics / Q000502:physiology; D007427:Intracranial Pressure; D007552:Isotonic Solutions / Q000627:therapeutic use; D008297:Male; D011460:Prostaglandins F / Q000097:blood*; D011680:Pupil / Q000502:physiology*; D011897:Random Allocation; D015203:Reproducibility of Results; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D012771:Shock, Hemorrhagic / Q000378:metabolism / Q000628:therapy*; D013929:Thromboxane B2 / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007552:Isotonic Solutions; D011460:Prostaglandins F; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic; D013929:Thromboxane B2; C100006:prostaglandin F1