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Isolated Brain Trauma in Cats Triggers Rapid Onset of Hypovolemia

Bentzer, Peter LU and Grände, Per Olof LU (2017) In Neurocritical Care 26(3). p.450-456
Abstract

Background: Hemodynamic instability responsive to fluid resuscitation is common after a traumatic brain injury (TBI), also in the absence of systemic hemorrhage. The present study tests if an isolated severe TBI induces a decrease in plasma volume (PV). Methods: The study was performed in three groups of anesthetized and tracheostomized male cats (n = 21). In one group (n = 8), the cats were prepared with a cranial borehole (10 mm i.d) used to expose the brain to a fluid percussion brain injury (FPI) (1.90–2.20 bar), and two smaller cranial boreholes (4 mm i.d) for insertion of an intracranial pressure (ICP) and a microdialysis catheter. To differentiate the effect of FPI from that of the surgical preparation, a sham group was exposed... (More)

Background: Hemodynamic instability responsive to fluid resuscitation is common after a traumatic brain injury (TBI), also in the absence of systemic hemorrhage. The present study tests if an isolated severe TBI induces a decrease in plasma volume (PV). Methods: The study was performed in three groups of anesthetized and tracheostomized male cats (n = 21). In one group (n = 8), the cats were prepared with a cranial borehole (10 mm i.d) used to expose the brain to a fluid percussion brain injury (FPI) (1.90–2.20 bar), and two smaller cranial boreholes (4 mm i.d) for insertion of an intracranial pressure (ICP) and a microdialysis catheter. To differentiate the effect of FPI from that of the surgical preparation, a sham group was exposed to the same surgical preparation but no FPI trauma (n = 8). A control group had no brain trauma and no surgical preparation (n = 5). PV was determined by a 125I-albumin dilution technique. PV, electrolytes, pH, BE (base excess), hematocrit (Hct), PaO2, and PaCO2 were measured at baseline and after 3 h. Mean arterial pressure (MAP) was measured continuously. ICP was measured in the FPI and the sham group. Results: In the FPI group, PV decreased by 11.2 mL/kg from 31.7 mL/kg (p < 0.01) with a simultaneous increase in Hct and decrease in pH. In the sham group, PV decreased by 5.7 mL/kg from 32.7 mL/kg (p < 0.01). The control group showed no PV reduction. Conclusions: The results support that an isolated severe head trauma triggers a significant and rapid reduction in PV, most likely due to vascular leak.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Blood pressure, Fluid percussion trauma, Intracranial pressure, Plasma volume, Traumatic brain injury, Vascular leak
in
Neurocritical Care
volume
26
issue
3
pages
450 - 456
publisher
Humana Press
external identifiers
  • scopus:84994472434
  • wos:000402101100019
ISSN
1541-6933
DOI
10.1007/s12028-016-0348-5
language
English
LU publication?
yes
id
ddb862e9-e6dd-4cbe-b6dc-c63f62e43824
date added to LUP
2016-12-01 10:55:18
date last changed
2018-01-07 11:37:49
@article{ddb862e9-e6dd-4cbe-b6dc-c63f62e43824,
  abstract     = {<p>Background: Hemodynamic instability responsive to fluid resuscitation is common after a traumatic brain injury (TBI), also in the absence of systemic hemorrhage. The present study tests if an isolated severe TBI induces a decrease in plasma volume (PV). Methods: The study was performed in three groups of anesthetized and tracheostomized male cats (n = 21). In one group (n = 8), the cats were prepared with a cranial borehole (10 mm i.d) used to expose the brain to a fluid percussion brain injury (FPI) (1.90–2.20 bar), and two smaller cranial boreholes (4 mm i.d) for insertion of an intracranial pressure (ICP) and a microdialysis catheter. To differentiate the effect of FPI from that of the surgical preparation, a sham group was exposed to the same surgical preparation but no FPI trauma (n = 8). A control group had no brain trauma and no surgical preparation (n = 5). PV was determined by a <sup>125</sup>I-albumin dilution technique. PV, electrolytes, pH, BE (base excess), hematocrit (Hct), P<sub>a</sub>O<sub>2</sub>, and P<sub>a</sub>CO<sub>2</sub> were measured at baseline and after 3 h. Mean arterial pressure (MAP) was measured continuously. ICP was measured in the FPI and the sham group. Results: In the FPI group, PV decreased by 11.2 mL/kg from 31.7 mL/kg (p &lt; 0.01) with a simultaneous increase in Hct and decrease in pH. In the sham group, PV decreased by 5.7 mL/kg from 32.7 mL/kg (p &lt; 0.01). The control group showed no PV reduction. Conclusions: The results support that an isolated severe head trauma triggers a significant and rapid reduction in PV, most likely due to vascular leak.</p>},
  author       = {Bentzer, Peter and Grände, Per Olof},
  issn         = {1541-6933},
  keyword      = {Blood pressure,Fluid percussion trauma,Intracranial pressure,Plasma volume,Traumatic brain injury,Vascular leak},
  language     = {eng},
  number       = {3},
  pages        = {450--456},
  publisher    = {Humana Press},
  series       = {Neurocritical Care},
  title        = {Isolated Brain Trauma in Cats Triggers Rapid Onset of Hypovolemia},
  url          = {http://dx.doi.org/10.1007/s12028-016-0348-5},
  volume       = {26},
  year         = {2017},
}