| Cerebral hemodynamic effects of 7.2% hypertonic saline in patients with head injury and raised intracranial pressure. | |
| | |
MedLine Citation:
|
PMID: 10674757 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
The aim of the present study was to investigate the acute effects of 7.2% hypertonic saline (HS) on intracranial pressure (ICP), cerebral and systemic hemodynamics, serum sodium, and osmolality in 14 patients with moderate and severe traumatic brain injury (Glasgow Coma Scale < or =13) and raised ICP (>15 mm Hg) within the first 72 h postinjury. After CO2 reactivity and autoregulation were tested, each patient received a 15-min infusion of 7.2% HS (1,232 mEq/L, volume 1.5 mL/kg). ICP, serial hemodynamics, cerebral blood flow (CBF) estimated from cerebral arteriovenous oxygen content difference (AVDO2), and laboratory variables, including serum osmolality, electrolytes, urea, and creatinine were collected before infusion (T0) and at 5, 30, 60, and 120 min after (T5, T30, T60, T120). Urine output was measured 2 h before infusion and at T120. While CO2 reactivity was preserved in all patients, autoregulation was preserved in only four. ICP decreased to about 30% of base line (p = 0.0001) during the whole study period. During the first hour after infusion, cerebral perfusion pressure (p< or =0.04) and cardiac index (CI; p< or =0.01) increased, while systemic vascular resistance index fell (p< or =0.05). Heart rate increased (p< or =0.04) during the first 30 min. Pulmonary artery occlusion pressure (PAOP) increased (p = 0.004) at T5. There were no significant changes in mean arterial blood pressure (MABP), urine output, and estimated CBF. A significant positive correlation (r = 0.75; p = 0.02) between ICP and serum osmolality was found at T5. The administration of 7.2% HS in patients with traumatic brain injury significantly reduces ICP without significant changes in relative global CBF (expressed as 1/AVDO2), increases CI and transiently increases PAOP, without changing MABP and urine output. The correlation between changes in osmolality and ICP supports the hypothesis that HSS may in part decrease ICP by means of an osmotic mechanism. |
| | |
Authors:
|
F Munar; A M Ferrer; M de Nadal; M A Poca; S Pedraza; J Sahuquillo; A Garnacho |
Related Documents
:
|
18639157 - Sequential changes and recoveries of the motor evoked potential in experimental hyperte... 17914307 - Design and implementation of a portable physiologic data acquisition system. 8613857 - Brain tissue pressure gradients created by expanding frontal epidural mass lesion. 10957697 - Gender differences in regional brain response to visceral pressure in ibs patients. 2137047 - Circadian blood pressure changes and left ventricular hypertrophy in essential hyperten... 18639157 - Sequential changes and recoveries of the motor evoked potential in experimental hyperte... |
Publication Detail:
|
Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Journal of neurotrauma Volume: 17 ISSN: 0897-7151 ISO Abbreviation: J. Neurotrauma Publication Date: 2000 Jan |
Date Detail:
|
Created Date: 2000-03-09 Completed Date: 2000-03-09 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 8811626 Medline TA: J Neurotrauma Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 41-51 Citation Subset: IM |
Affiliation:
|
Department of Anesthesiology, Vall d'Hebron University Hospitals, Barcelona, Spain. davaz@i3d.es |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Blood Pressure / drug effects Brain Injuries / blood, complications, drug therapy* Cerebrovascular Circulation / drug effects* Chlorides / blood Female Hemodynamics / drug effects Hemoglobins / metabolism Humans Infusions, Intravenous Intracranial Hypertension / drug therapy*, etiology Male Middle Aged Osmolar Concentration Potassium / blood Prospective Studies Saline Solution, Hypertonic / administration & dosage* Sodium / blood Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Chlorides; 0/Hemoglobins; 0/Saline Solution, Hypertonic; 7440-09-7/Potassium; 7440-23-5/Sodium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Extracellular N-acetyl-aspartate as a biochemical marker of the severity of neuronal damage followin...
Next Document: Characterization of plasma magnesium concentration and oxidative stress following graded traumatic b...