The Research Of Treatment Of HSH In Cat Brain Injury

Severe head injury is the most frequent cause of death in patients with trauma. Injury to the brain is often accompanied by cerebral edema and swelling or space-occupying hematomas that can lead to increased intracranial pressure(ICP), reduced cerebral blood flow(CBF), and a secondary ischemic injury. A normal cerebral perfusion pressure(CPP) is particularly significant in averting ischemic injury to brain that already has suffered a primary trauma. Small-volume resuscitation in severe hemorrhagic shock by hypertonic saline and/or its complex has been shown to instantaneously normalize cardiac output and to raise systemic blood pressure.Object: In cat middle brain injury model , hypertonic sodium chloride hydroxyethylstarch-40 injection (HSH 8ml/kg) was compared with hypertonic mannitol (MAN 5ml/kg) and Ringer's lactate (RL 8ml/kg) to investigate their therapeutic efficacy in intracranial hypertension and brain edema as to provide basis for clinc therapy. Methods: Middle brain injury model was performed in cats subjected to fluid-percussion traumatic brain injury. 3 hours later each animal was received rapidly intravenous administration of either HSH or of 20%mannitol or of RL. Data(ICP,BP,HCT and serum Na+ ) were collected at baseline, at 0, 30, 60, 90, and 120 minutes after the injection. At sacrifice, the water content of the injured and uninjured hemisphere was measured. The ultrastructure changes of brain tissue were observed.Result: After the injection, ICP lowering was seen in the groups of HSH and MAN, whereas no differences in duration of ICP lowering were found(P>0.05); there were no ICP lowering found in RL group. No differences in brain tissue water content in the injured hemisphere in the three groups were observed(P>0.05). Brain tissue water content in the uninjured hemisphere in the groups of HSH and mannitol were significant decreased compared to that of RL(P<0.05), though no differences between them(P>0.05). There were no differences in blood HCT(P>0.05). Plama-Na+ at 30,60 and 90 minutes after the injection of HSH significantly increased. After the injection of the HSH and mannitol, the systemic blood pressure tend to decrease with the dropping of ICP, though it might be slightly lowerer in the group of mannitol, but as the ICP increased, it would also increased. No difference were observed in blood pressure and CPP in the three group(P>0.05). The changes of brain tissue ultrastructure in the injured hemisphere in the groups of HSH and MAN are better than that in the the group of RL.Conclusion: The present finding demonstrate that HSH was as efficient as the mannitol in traumatic intracranial hypertension and brain edema by decreasing ICP and reducing cerebral water content in the uninjured hemisphere, and it can maintain blood pressure. The treatment of severe brain injury in clinic would choose HSH as a efficient resuscitation fluid.