Effects of Fluid Resuscitation on Cerebral Protection in A Rat Model of Traumatic Head Injury Complicated with Hemorrhagic Shock

ObjectiveTo compare the effects of normal saline (NS), 10% hydroxyethyl starch (HES) and hypertonic-hyperoncotic solution (HHS,7.5% NaCl/10% HES) on regional cerebral blood flow (rCBF), brain edema and blood-brain barrier (BBB) in a rat model of traumatic head injury (THI) complicate with hemorrhagic shock. Methods60 SD rats were randomized into 5 groups: sham group (n=12), model group (n=12), NS group (n=12), HES group (n=12) and HHS group (n=12). rCBF and mean arterial pressure (MAP) were determined before and after THI, hemorrhagic shock and resuscitation. Cerebral water content and Evans Blue (EB) content were assessed 3 h after resuscitation.ResultsMAP and rCBF were restored to baseline values immediately after resuscitation in all resuscitated group and began to decrease 15 min, 30 min or 45 min later, respectively(P0.05). 3 h after resuscitation, the brain water content was higher in NS group than those in sham or HHS group(P0.05). EB contents of injured hemispheres were higher in model and NS group than those in HES or HHS group(P0.05). ConclusionSmall-volume resuscitation with HHS can restore MAP and rCBF, decrease brain edema and improve BBB in a rat model of THI complicate with hemorrhagic shock.