Small Volume Resuscitation in Hemorrhagic Shock by Hypertonic/Hyperoncontic Saline-Dextran: Effects on the Central Nervous System
Secondary ischemia of the brain is common in fatal head injury (Graham et al. 1989). Bouma et al. (1991) observed in patients a close correlation between the impairment of cerebral blood flow during the first hours after trauma and final outcome. Based on the United States traumatic coma databank study, Marmarou et al. (1991) reported that periods of elevated intracranial pressure (ICP) (>20mmHg) or of a decreased blood pressure (<80mmHg) were highly predictive for poor outcome from severe head injury. Since 10%-20% of head-injured patients are simultaneously affected by severe peripheral injuries causing hemorrhagic hypotension (Miller et al. 1978), primary care must reestablish and maintain an appropriate cerebral as well as systemic circulation.
KeywordsMean Arterial Pressure Head Injury Intracranial Hypertension Hemorrhagic Shock Hypertonic Saline
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