Cerebral blood flow following hypertonic saline resuscitation in an experimental model of hemorrhagic shock and head injury.

Hypertonic (3.0%) saline (HS) resuscitation from hemorrhagic shock is associated with less cerebral edema and lower intracranial pressure (ICP) compared to normal saline (NS) and 10% Dextran 40 (D-40). The effect of HS resuscitation on cerebral blood flow (CBF) is unknown. Beagle dogs with a head injury underwent shock and resuscitation, receiving either NS (N = 6), HS (N = 6), or D-40 (N = 6). CBF (via a microsphere technique) and ICP were measured at baseline (BL) and at end shock (ES) after infusion of shed blood and test fluid (ER) and 2 hours after resuscitation (LR). CBF was determined globally (GCBF), and for the right (RCBF) and left (LCBF) cerebral hemispheres. ICP values (+/- SEM) at BL and ES were 10.8 +/- 1.31 mmHg and 8.0 +/- 1.67 mmHg, respectively, for all groups. GCBF, RCBF and LCBF at BL were 29.4 +/- 5.04, 26.7 +/- 4.93 and 26.6 +/- 4.50 ml 100 g-1 min-1, respectively. ES values for CBF were not significantly different from BL. Global and hemispheric CBF values were not different between groups at times measured. ICP was significantly lower in animals receiving HS. Therefore, lower ICP following HS resuscitation is not associated with alteration in CBF.