Effects On Intracranial Pressure In a Clinically Derived Fluid Resuscitation Protocol Following Hemorrhagic Shock with an Accompanying Intracranial Mass

Abstract

We have previously shown, in a hemorrhagic shock — intracranial mass model, that isotonic crystalloid results in a greater and more rapid increase in ICP immediately following resuscitation than hypertonic crystalloid, colloid or a combination of crystalloid and colloid (Whitley 1988). This rapid increase in ICP may exacerbate the neurological sequelae of the shock episode by decreasing CBF following resuscitation. While the effects of resuscitation on ICP have been extensively studied, they have dealt only with the effects of a single resuscitation fluid bolus, unlike the clinical protocol where systemic hemodynamics are maintained. The present study compared the cerebrovascular effects of resuscitation with isotonic and hypertonic crystalloid, each with and without colloid (10% Pentastarch), while maintaining cardiac output above baseline levels in a hemorrhagic shock — intracranial mass model.