Abstract
Albino rabbits who had undergone a cryogenic insult over the left parieto-occipital cortex 24 hours previously were analyzed for serum osmolality, serum electrolytes, brain water content, intracranial pressure (ICP), following a 3 hour baseline intravenous infusion of above maintenance isotonic saline, and compared to sham operated controls.
In the acute setting there was no difference in the serum osmolality and electrolytes between the subgroups. There was a significant increase in the water content of the white matter of the left hemisphere in the cold lesion group when compared to sham operated controls. Despite the intravenous fluid challenge, the ICP did not rise during the 3 hour experimental trial when compared to pre-trial values.
It is concluded that in the acute setting an isotonic fluid load is compensated without significant disturbances of the above measured parameters, and should not alter therefore intracranial dynamics per se, in acute resuscitation measures following brain insults.
Keywords
This work was supported in part by Research Funds from the Division of Neurosurgery and by the Foundation for Pediatric and Laser Neurosurgery, Inc., San Diego. California.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
DownesJJ, Raphaely RC (1979) Anesthesia and intensive Care. In: Ravitch MM, Welch KJ,Benson CD, etal(eds)Pediatric surgery, Vol 2. Year Book Medical Publishers, Chicago, 1979, pp 12–38
Perkin RM (1985)Pathophysiology of childhood shock syndromes. In: James HE, Anas NG, Perkin RM(eds) Brain insults in infants and children. Grune and Stratton, Orlando, pp191–198
Carrico CJ,Canizaro PC, Shires GT (1976) Fluid resuscitation following injury: rationalefor the use of balanced salt solutions. Crit Care Med 4: 46–54
Fishman RA (1953)Effects of isotonic intravenous solutions on normal and increased intracranialpressure. Arch Neurol Psychiatry 70: 350–360
Lucas CE, WeaverD, Higgins RF, Ledgerwood AM, Johnson SD (1978) Effects of albumin versusnon-albumin resuscitation on plasma volume and renal excretory function. JTrauma 18: 564–570
Lucas CE,Ledgerwood AM, Higgins RF, Weaver DW (1980) Impaired pulmonary function afteralbumin resuscitation from shock. J Trauma 20: 446–451
Rowe MI, Arango A(1975) The choice of intravenous fluid in shock resuscitation. Pediatr Clin North Am 22: 269–274
Shenkin HA, Bezier HS, Bouzarth WF(1976) Restricted fluid intake. Rational management of the neurosurgicalpatient. J Neurosurg 45: 432–436
Gunnar W,Jonasson O, Merlotti G, Stone J, Barrett J (1988) Head injury and hemorrhagicshock: studies of the blood brain barrier and intracranial pressure afterresuscitation with normal saline solution, 3% saline solution, and dextran-40.Surgery 103: 398–408
Tommasino C,Moore S, Todd MM (1988) Cerebral effects of isovolemic hemodilution withcrystalloid or colloid solutions. Crit Care Med 16: 862–868
James HE, Laurin RA (1981) Intracranial hypertension and brain oedema in albino rabbits. Part 1:experimental models. Acta Neurochir (Wien) 55: 213–226
Herrmann HD, Neuenfeldt D(1972) Development and regression of a disturbance of the blood brain barrierand of edema in tissue surrounding a circumscribed cold lesion. Exp Neurol 34:115–120
Ferszt R, Hahm H,Cervos-Navarro J (1980) Measurement of the specific gravity of the brain as atool in brain edema research. In: Cervos-Navarro J, Ferszt R (eds) Advances inneurology, Vol 28. Brain edema. Raven, New York, pp 15–26
JamesHE, Langfitt TW, Kumar VS, Ghostine SY (1977) Treatment of intracranialhypertension: analysis of 105 consecutive, continuous recordings ofintracranial pressure. Acta Neurochir (Wien) 36: 189–200
Langfitt TW(1972) Pathophysiology of increased ICP. In: Brock M, Dietz H (eds)Intracranial pressure. Springer Berlin Heidelberg New York, pp 361–364
Rowan JO,Johnston IH, Harper AM, Jennett WB (1972) Perfusion pressure inintracranial hypertension. In: Brock M, Dietz H (eds) Intracranial pressure.Springer, Berlin Heidelberg New York, pp 165–170
VirgilioRW, Smith DE,ZarinsCK (1979) Balanced electrolyte solutions: experimental and clinical studies.Crit Care Med 7: 98–106
Fishman RA, ChanPH (1980) Metabolic basis of brain edema. In: Cervos-Navarro J, Ferszt R (eds)Advances in neurology, Vol 28. Brain edema. Raven, New York, pp 207–215
Bakay L, Crawford JD, White JC (1954) Effects of intravenous fluids on cerebrospinal fluidpressure. Surg Gynecol Obstet 99: 48–52
Fox JL, Falik JL,Shalhoub RJ (1971) Neurosurgical hyponatremia: the role of inappropriateantidiuresis. J Neurosurg 34: 506–514
McLaurin RL, KingLR, Elam EB, Budde RB (1960) Metabolic response to craniocerebral trauma. SurgGynecol Obstet110:282–288
Wise BL (1965)Fluid and electrolytes in neurological surgery. Thomas, Springfield, Ill
Shenkin HA,Bouzarth WF, Tatsumi T (1968) The analysis of body water compartments inpostoperative craniotomy patients. 1. The effects of major brain surgery alone.2. The effects of mannitol administered preoperatively. J Neurosurg 28: 417–428
Shenkin HA,Gutterman P (1969) The analysis of body water compartments in postoperativecraniotomy patients. The effects of dexamethasone. J Neurosurg 31: 400–407
Steinbok P,Thompson GB (1978) Metabolic disturbances after head injury: abnormalities ofsodium and water balance with special reference to the effects of alcoholintoxication. Neurosurgery 3: 9–15
Aikawa JK (1950)Fluid volumes and electrolyte concentrations in normal rabbits. Am J Physiol162: 695–702
Klatzo I,Wisniewski H, SteinwallO, StreicherE(1976) Dynamics of cold injury edema. In: Klatzo I, Seitelberger F (eds) Brainedema. Springer, Berlin Heidelberg New York, pp 554–563
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1993 Springer-Verlag
About this paper
Cite this paper
James, H.E., Schneider, S. (1993). Effects of Acute Isotonic Saline Administration on Serum Osmolality, Serum Electrolytes, Brain Water Content and Intracranial Pressure. In: Baethmann, A., Kempski, O., Schürer, L. (eds) Mechanisms of Secondary Brain Damage. Acta Neurochirurgica, vol 57. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9266-5_13
Download citation
DOI: https://doi.org/10.1007/978-3-7091-9266-5_13
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-9268-9
Online ISBN: 978-3-7091-9266-5
eBook Packages: Springer Book Archive