LACTATED RINGER SOLUTION ALLEVIATES BRAIN TRAUMA-PRECIPITATED LACTIC-ACIDOSIS IN HEMORRHAGIC-SHOCK

To determine the influence of brain trauma on blood acid-base and lact ate-pyruvate responses to hemorrhage, and the effect of lactated Ringe r's solution on these responses, 30 anesthetized rats were assigned to four groups: hemorrhage (n = 7), hemorrhage following fluid percussio n brain trauma (trauma-hemorrhage group) (n = 7), hemorrhage treated w ith lactated Ringer's solution (hemorrhage-resuscitation group) (n = 8 ), and hemorrhage following brain trauma treated with lactated Ringer' s solution (trauma-hemorrhage-resuscitation group) (n = 8). The hemorr hage group showed no significant changes in pH, HCO3, and base excess after hemorrhage. Base excess and pH were significantly reduced after the hemorrhage in the trauma-hemorrhage group but were raised after re suscitation in the hemorrhage-resuscitation group. Acid-base values sh owed no difference between the trauma-hemorrhage-resuscitation and hem orrhage groups. The trauma-hemorrhage-resuscitation group also had a s ignificantly higher base excess than the trauma-hemorrhage group. Lact ate rose significantly after hemorrhage in the hemorrhage group and wa s even higher in the trauma-hemorrhage group, but there were no differ ences between the hemorrhage versus hemorrhage-resuscitation or trauma -hemorrhage-resuscitation groups. Both brain trauma and lactated Ringe r's solution increased pyruvate with marked reduction in the ratio of lactate to pyruvate. These data indicate that brain trauma precipitate s blood lactate accumulation and metabolic acidosis after hemorrhage, and infusion of lactated Ringer's solution can relieve these disturban ces.