Resuscitation from severe hemorrhagic shock after traumatic brain injury using saline, shed blood, or a blood substitute

Shock
Jeffrey B GibsonK G Proctor

Abstract

The original purpose of this study was to compare initial resuscitation of hemorrhagic hypotension after traumatic brain injury (TBI) with saline and shed blood. Based on those results, the protocol was modified and saline was compared to a blood substitute, diaspirin cross-linked hemoglobin (DCLHb). Two series of experiments were performed in anesthetized and mechanically ventilated (FiO2 = 0.4) pigs (35-45 kg). In Series 1, fluid percussion TBI (6-8 ATM) was followed by a 30% hemorrhage. At 120 min post-TBI, initial resuscitation consisted of either shed blood (n = 7) or a bolus of 3x shed blood volume as saline (n = 13). Saline supplements were then administered to all pigs to maintain a systolic arterial blood pressure (SAP) of >100 mmHg and a heart rate (HR) of <110 beats/min. In Series 2, TBI (4-5 ATM) was followed by a 35% hemorrhage. At 60 min post-TBI, initial resuscitation consisted of either 500 mL of DCLHb (n = 6) or 500 mL of saline (n = 5). This was followed by saline supplements to all pigs to maintain a SAP of >100 mmHg and a HR of <110 beats/min. In Series 1, most systemic markers of resuscitation (e.g., SAP, HR, cardiac output, filling pressures, lactate, etc.) were normalized, but there were 0/7 vs. 5/13 deat...Continue Reading

References

Jan 1, 1993·Journal of Neurotrauma·D L HiltonJ T Robertson
Feb 1, 1993·The Journal of Trauma·R M ChesnutM A Foulkes
Feb 1, 1993·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·D J ColeS Marcantonio
Oct 1, 1995·Journal of Neurotrauma·C S RobertsonR K Narayan
Mar 1, 1997·Critical Care Medicine·S M CohnB T Fisher
Jul 1, 1997·Journal of Neurotrauma·W L MaxwellD L Graham
Apr 13, 1999·The American Journal of Physiology·S FischerG F Karliczek
Nov 5, 1999·Critical Care Medicine·C S RobertsonR G Grossman
Feb 2, 2000·Microcirculation : the Official Journal of the Microcirculatory Society, Inc·M Intaglietta

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Citations

Oct 28, 2003·Journal of Neurotrauma·Ajai K MalhotraKenneth G Proctor
Sep 11, 2008·Journal of Neurotrauma·Alia Marie DennisPatrick M Kochanek
Apr 19, 2005·Shock·Marc MaegeleEdmund A M Neugebauer
Sep 2, 2005·Shock·Ernest E MooreAnirban Banerjee
Sep 30, 2004·The Journal of Trauma·Bruce A CrookesKenneth G Proctor
Jun 10, 2006·The Journal of Trauma·Thomas B RepineLorne Blackborne
Jul 13, 2006·The Journal of Trauma·Mayur B PatelKenneth G Proctor
Sep 13, 2006·The Journal of Trauma·Andrew P CarlsonStephen W Lu
Nov 2, 2006·Current Opinion in Critical Care·Lauralyn A McIntyre, Paul C Hebert
Jul 19, 2008·Shock·Takeshi Tsukamoto, Hans Christoph Pape
Jul 17, 2013·Shock·Frank HildebrandMartijn van Griensven
Jan 11, 2007·Critical Care : the Official Journal of the Critical Care Forum·Hendrik BrachtStephan M Jakob
Jun 13, 2009·Critical Care : the Official Journal of the Critical Care Forum·Andreas H Kramer, David A Zygun
Jan 4, 2006·NeuroRx : the Journal of the American Society for Experimental NeuroTherapeutics·Ibolja Cernak
Feb 19, 2011·Journal of Biomedicine & Biotechnology·Michael FrinkFrank Hildebrand
Dec 6, 2014·Journal of Pediatric Surgery·Casey J AllenJuan E Sola
Nov 28, 2012·Journal of the American College of Surgeons·Chad M ThorsonKenneth G Proctor
Oct 18, 2012·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Lesley M FoleyPatrick M Kochanek
Sep 21, 2011·Paediatric Anaesthesia·Gianluca BertolizioAndre Obenaus
Sep 15, 2004·International Journal of Pharmaceutics·V D AwasthiB A Goins
Dec 6, 2005·Transfusion clinique et biologique : journal de la Société française de transfusion sanguine·C P Stowell
Oct 11, 2005·Surgery·Steven A EarleMatthias Majetschak
Sep 27, 2005·Journal of the American College of Surgeons·Ara J FeinsteinKenneth G Proctor
Feb 9, 2012·The Journal of Trauma and Acute Care Surgery·Mark L RyanKenneth G Proctor
Apr 14, 2010·Journal of Neuroscience Methods·Neelima B ChauhanMihirsinh B Chauhan
Nov 12, 2014·Journal of Intensive Care Medicine·James N BogertBryan A Cotton
Jan 19, 2018·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Akiva LeibowitzMatthew Boyko
Feb 27, 2020·The Journal of Trauma and Acute Care Surgery·Charlie J NederpeltHaytham M A Kaafarani
Nov 19, 2002·The Journal of Trauma·Matthew J Fabian, Kenneth G Proctor
Sep 30, 2016·Brain Injury : [BI]·Sarah TraversN Scott Litofsky
Jul 1, 2019·Neuroscience and Biobehavioral Reviews·Andrew R MayerSheila M Alonzo

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