Effects and mechanisms of four different complex solutions on acute intracranial hypertension complicated by hemorrhagic shock resuscitation in rabbits

Abstract

Objective To observe the effect of four different solutions in treatment of acute intracranial hypertension complicated by hemorrhagic shock in rabbits,and explore their mechanisms.Methods Twenty four rabbits were randomized into four equal groups,namely the mannitol hydroxyethyl starch ( MT + HS) group,mannitol low molecule dextran ( MT + HD) group,7.5％ hypertonic sodium chloridehydroxyethyl starch (HSH) group,7.5％ hypertonic sodium chloride low molecule dextran (HSD) group.Cannie models of acute intracranial hypertension complicated by hemorrhagic shock in rabbits were established by epidural ballon inflation with saline and rapid discharge of the arterial blood.Monitor mean arterial pressure (MAP),central venous pressure (CVP),ICP,CPP before starting the experiment (E1),after epidural ballon inflation ( E2 ),during shock phase after rapid discharge of the arterial blood ( E3 ),20min after shock ( F4 ),20min after resuscitation ( T1 ),40 min after resuscitation ( T2 ),1 h after resuscitation (T3),2 h after resuscitation (T4),respectively.Results All four solutions can effectively increase MAP.20 min after resuscitation,MAP values of rabbits in HSH group show the fastest response to reach peak.They display an average of improvement of ( 29.4 ± 2.1 ),( 29.4 ± 2.1 ),(41.0 ± 2.2),(40.6 ± 1.6) mm Hg ( 1 mm Hg =0.133 kPa) in MAP,respectively.The difference of improvement has statistical significance( P ＜ 0.05 ) ; All four complex solutions can improve about ( 3.0 ± 1.4) cm H2O (1 cm H2O =0.098 kPa) in CVP,and the difference of improvement has no statistical significance( P ＞0.05) ;All four complex solutions can decrease ICP value to the baseline level (7.3 ± 1.6) mm Hg and increase CPP value tothe base-line level ( 69.6 ± 6.8 ) mmHg at different time points.The difference of their peak values show no statistical significance(P ＞ 0.05).Conclusion All four solutions can effectively resuscitate hemorrhagic shock and decrease ICP.HSH has the longest-lasting effect and shows the best result from resuscitation of hemorrhagic shock. Key words: Acute intracranial hypertension; Hemorrhagic shock