Effects of hypertonic saline versus lactated Ringer's solution on cerebral oxygen transport during resuscitation from hemorrhagic shock

Donald Prough, J. C. Johnson, D. A. Stump, E. H. Stullken, G. V. Poole, G. Howard

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Hypertonic saline successfully restores systemic hemodynamics in dogs and humans with severe hemorrhagic shock and, in contrast to lactated Ringer's solution, does not increase intracranial pressure (ICP). This study compares cerebral oxygen delivery in 12 dogs subjected to hemorrhagic shock by the rapid removal of blood (mean arterial pressure of 40 mm Hg maintained for 30 minutes), and then resuscitated with lactated Ringer's solution (six dogs) or 7.5% saline solution (six dogs) to restore systolic arterial pressure. Both solutions effectively restored systemic hemodynamic stability, increase cardiac output and systolic blood pressure while decreasing mean and diastolic arterial pressure and systemic vascular resistance. The ICP was significantly lower after resuscitation in the hypertonic saline group (p < 0.05), but cerebral blood flow, which had decreased during shock, was not restored by either fluid, and cerebral oxygen transport fell further secondary to a hemodilutional reduction of hemoglobin. Although hypertonic saline may improve systemic hemodynamics and maintain a low ICP during resuscitation, it fails, as does Ringer's solution, to restore cerebral oxygen transport to prehemorrhagic shock levels.

Original languageEnglish (US)
Pages (from-to)627-632
Number of pages6
JournalJournal of Neurosurgery
Volume64
Issue number4
StatePublished - 1986
Externally publishedYes

Fingerprint

Hemorrhagic Shock
Resuscitation
Dogs
Oxygen
Blood Pressure
Arterial Pressure
Hemodynamics
Intracranial Pressure
Shock
Cerebrovascular Circulation
Intracranial Hypertension
Sodium Chloride
Cardiac Output
Vascular Resistance
Hemoglobins
Ringer's solution
Ringer's lactate

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Effects of hypertonic saline versus lactated Ringer's solution on cerebral oxygen transport during resuscitation from hemorrhagic shock. / Prough, Donald; Johnson, J. C.; Stump, D. A.; Stullken, E. H.; Poole, G. V.; Howard, G.

In: Journal of Neurosurgery, Vol. 64, No. 4, 1986, p. 627-632.

Research output: Contribution to journalArticle

Prough, Donald ; Johnson, J. C. ; Stump, D. A. ; Stullken, E. H. ; Poole, G. V. ; Howard, G. / Effects of hypertonic saline versus lactated Ringer's solution on cerebral oxygen transport during resuscitation from hemorrhagic shock. In: Journal of Neurosurgery. 1986 ; Vol. 64, No. 4. pp. 627-632.
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