Prehospital Whole Blood Resuscitation Reduces Fluid Requirement While Maintaining Critical Physiology in a Model of Penetrating Traumatic Brain Injury and Hemorrhage: Implications on Resource-Limited Combat Casualty Care
| Autor: | Deborah Shear, Xiaofang Yang, Janice Gilsdorf, Zachary S. Bailey, Patrick M. Kochanek, Lai Yee Leung, Katherine Cardiff |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Emergency Medical Services Resuscitation Mean arterial pressure Traumatic brain injury Physiology Hemorrhage 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine Cerebral edema Rats Sprague-Dawley Random Allocation 03 medical and health sciences 0302 clinical medicine Bolus (medicine) Edema medicine Animals Head Injuries Penetrating Blood Transfusion Cerebral perfusion pressure business.industry 030208 emergency & critical care medicine medicine.disease Rats Oxygen tension Disease Models Animal Emergency Medicine Fluid Therapy Health Resources War-Related Injuries medicine.symptom business |
| Zdroj: | Shock. 55:545-553 |
| ISSN: | 1540-0514 1073-2322 |
| Popis: | Prehospital resuscitation using whole blood (WB) is the standard of care for hemorrhagic shock (HS) but there is no consensus recommendation for resuscitation in the presence of traumatic brain injury (TBI) due to a lack of sufficient evidence. In order to evaluate the optimal resuscitation strategies for TBI+HS, Sprague-Dawley rats were randomized into four groups based on resuscitation fluid and prehospital mean arterial pressure (MAP) threshold (n = 9-10/group): Lactated Ringer's (LR)-60 mm Hg (LR60), LR-70 mm Hg (LR70), WB-60 mm Hg (WB60), WB-70 mm Hg (WB70). All groups received a frontal penetrating ballistic-like brain injury followed by a 35-min period of HS. During the prehospital phase, rats received an initial bolus of resuscitation fluid (WB or LR) followed by LR as needed to maintain MAP above the designated threshold for 90 min. During the in-hospital phase, rats received definitive resuscitation with shed WB. Physiological parameters were recorded continuously and cerebral edema was measured at 3 and 24 h postinjury. The WB60 group demonstrated a significantly lower prehospital fluid requirement compared WB70, LR60, and LR70 (P |
| Databáze: | OpenAIRE |
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