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Resuscitation of Traumatic Brain Injury and Hemorrhagic Shock with Polynitroxylated Albumin, Hextend, Hypertonic Saline, and Lactated Ringer's: Effects on Acute Hemodynamics, Survival, and Neuronal Death in Mice
Journal of Neurotrauma
  • Jennifer L. Exo, University of Pittsburgh School of Medicine
  • David K. Shellington, University of Pittsburgh School of Medicine
  • Hülya Bayır, University of Pittsburgh School of Medicine
  • Vincent A. Vagni, Safar Center for Resuscitation Research
  • Keri Janesco-Feldman, Safar Center for Resuscitation Research
  • Li Ma, Georgia Southern University
  • Carleton J. C. Hsia, SynZyne Technologies LLC
  • Robert S. B. Clark, University of Pittsburgh School of Medicine
  • Larry W. Jenkins, University of Pittsburgh School of Medicine
  • C. Edward Dixon, University of Pittsburgh School of Medicine
  • Patrick M. Kochanek, University of Pittsburgh School of Medicine
Document Type
Article
Publication Date
12-1-2009
DOI
10.1089/neu.2009.0980
Disciplines
Abstract

Outcome after traumatic brain injury (TBI) is worsened by hemorrhagic shock (HS), but the optimal resuscitation approach is unclear. In particular, treatment of TBI patients with colloids remains controversial. We hypothesized that resuscitation with the colloids polynitroxylated albumin (PNA) or Hextend (HEX) is equal or superior to resuscitation with the crystalloids hypertonic (3%) saline (HTS) or lactated Ringer's solution (LR) after TBI plus HS in mice. C57/BL6 mice (n = 30) underwent controlled cortical impact (CCI) and 90 min of volume-controlled HS (2 mL/100 g). The mice were randomized to resuscitation with LR, HEX, HTS, or PNA, followed by 30 min of test fluid administration targeting a mean arterial pressure (MAP) of >50 mm Hg. Shed blood was re-infused to target a MAP >70 mm Hg. At 7 days post-insult, hippocampal neuron counts were assessed in hematoxylin and eosin–stained sections to quantify neuronal damage. Prehospital MAP was higher, and prehospital and total fluid requirements were lower in the PNA and HEX groups (p < 0.05 versus HTS or LR). Also, 7-day survival was highest in the PNA group, but was not significantly different than the other groups. Ipsilateral hippocampal CA1 and CA3 neuron loss did not differ between groups. We conclude that the colloids PNA and HEX exhibited more favorable effects on acute resuscitation parameters than HTS or LR, and did not increase hippocampal neuronal death in this model.

Citation Information
Jennifer L. Exo, David K. Shellington, Hülya Bayır, Vincent A. Vagni, et al.. "Resuscitation of Traumatic Brain Injury and Hemorrhagic Shock with Polynitroxylated Albumin, Hextend, Hypertonic Saline, and Lactated Ringer's: Effects on Acute Hemodynamics, Survival, and Neuronal Death in Mice" Journal of Neurotrauma Vol. 26 Iss. 12 (2009) p. 2403 - 2408
Available at: http://works.bepress.com/li_ma/27/