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

BACKGROUND: Head injury outcome is adversely affected by the presence of hypotension. Therapies directed at rapidly correcting hypotension may improve outcome. METHODS: In 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. RESULTS: Small-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.