Effect of Small-volume Resuscitation on Intracranial Pressure and Related Cerebral Variables

BACKGROUNDHead injury outcome is adversely affected by the presence of hypotension. Therapies directed at rapidly correcting hypotension may improve outcome. METHODSIn two separate studies, we investigated small-volume resuscitation (4 mL/kg) using Ringer's lactate, hypertonic saline and dextran, and diaspirin cross-linked hemoglobin in a porcine model of cryogenic brain injury and shock. RESULTSSmall-volume resuscitation with hypertonic saline and dextran and diaspirin cross-linked hemoglobin significantly improved mean arterial pressure and cerebral perfusion pressure compared with Ringer's lactate. These data suggest that small-volume resuscitation with hypertonic saline and dextran or diaspirin cross-linked hemoglobin may effectively limit or prevent secondary ischemic brain injury after head injury and shock.