The effect of treatment with albumin, hetastarch, or hypertonic saline on neurological status and brain edema in a rat model of closed head trauma combined with uncontrolled hemorrhage and concurrent resuscitation in rats

In rats subjected to closed head trauma (CHT) plus uncontrolled hemorrhage, giving 0.3 mL of 0.9% saline per 0.1 mL of blood lost did not restore mean arterial blood pressure (MAP) or improve neurological severity score (NSS) . In CHT without hemorrhage, giving 20% albumin or 10% hetastarch improved NSS. We hypothesized that these latter treatments would also improve NSS af ter CHT plus uncontrolled hemorrhage. Rats were randomly assigned to one of seven groups. Experimental conditions were CHT (yes or no), uncontrolled h emorrhage (yes or no), and fluid given to replace blood loss (none; 10% het astarch, 20% albumin, or 3% saline [0.1 mL per 0.1 mt of blood lost]; or 0. 9% saline [0.3 mt per 0.1 mL of blood lost]). NSS (0-25 scale, where 0 = no impairment) was determined at 1, 4, and 24 h, and brain water content was determined at 24 h after CHT. NSS (median +/- range) at 24 h was 11 +/- 6 w hen no fluid was given; 16 +/- 5 with 10% hetastarch; 14 +/- 5 with 20% alb umin; 12 +/- 4 with 3% saline; and 13 +/- 4 with 0.9% saline given (not sig nificant). In addition, brain water content and MAP did not differ among th e groups receiving CHT with or without uncontrolled hemorrhage. In our mode l of CHT plus uncontrolled hemorrhage in rats, giving 10% hetastarch, 20% a lbumin, 3% saline, or 0.9% saline failed to improve NSS, brain water conten t, or MAP.