INITIAL SMALL-VOLUME HYPERTONIC RESUSCITATION OF SHOCK AND BRAIN INJURY - SHORT-TERM AND LONG-TERM EFFECTS

Background: Initial small-volume hypertonic saline resuscitation of a combined hemorrhagic shock and head injury model was studied Methods: Twenty-three sheep underwent hemorrhage (20 mL/kg) and parietal freeze injury followed by initial bolus resuscitation with lactated Ringer's solution (40 mL/kg) or 7.5% hypertonic saline (EPS) (4 mL/kg). Cardia c index was maintained with lactated Ringer's solution for either 2 or 24 hours, Parietal lobe water content, blood volume, and blood flaw w ere determined, Intracranial pressure (millimeters of mercury) was fol lowed. Results: Overall fluid requirements (milliliters per kilogram) were less at 2 and 24 hours with HS resuscitation, Early intracranial pressure was less with HS resuscitation. Brain water contents were sim ilar between groups, Blood flow in injured and blood volume in uninjur ed parietal lobe: were less for AS at 2 hours, although not different at 24 hours. Conclusions: Less fluid was needed in the short- and long -term with HS resuscitation. Early intracranial pressure was higher wi th lactated Ringer's solution resuscitation, possibly in part owing to increased blood volume.