Abstract
The effects of shock and resuscitation on the cerebral circulation have been incompletely characterized. Few clinical data are available because of the ethical and methodologic problems involved in acute measurements of cerebral blood flow (CBF), the cerebral metabolic rate for oxygen (CMRO2), and intracranial pressure (ICP) in unstable humans. However, animal data define the effects of hemorrhagic hypotension, of endotoxic shock, of fluid resuscitation after shock, and of isovolumic hemodilution. Considerable data are available regarding the effects of shock and resuscitation in animals with intracranial mass lesions and experimental head injury.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Michenfelder JD, Theye RA: Canine systemic and cerebral effects of hypotension induced by hemorrhage, trimethaphan, halothane, or nitroprusside. Anesthesiology 46:188–195, 1977.
Gregory PC, McGeorge AP, Fitch W, et al: Effects of hemorrhage hypotension on the cerebral circulation. II. Electrocortical function. Stroke 10:719–23, 1979.
Graham DI, Fitch W, MacKenzie ET, Harper AM: Effects of hemorrhagic hypotension on the cerebral circulation. III. Neuropathology. Stroke 10:724–7, 1979.
Prough DS, Johnston JC, Stullken EH, et al: Effects on cerebral hemodynamics of resuscitation from endotoxic shock with hypertonic saline versus lactated Ringer's solution. Crit Care Med 13:1040–4, 1985.
Ekström-Jodal B, Häggendal J, Larsson LE, et al: Cerebral hemodynamics, oxygen uptake and cerebral arteriovensou differences of catecholamines following E. coli endotoxin in dogs. Acta Anaesth Scand 26:446, 1982.
Ekström-Jodal B, Larsson LE: The effects of high dose methylprednisolone or fluid volume expansion on cerebral haemodynamics and oxygen uptake in endotoxic shock: an experimental study in dogs. Crit Care Med 10:375, 1982.
Miller CF, Breslow MJ, Shapiro RM, Traystman RJ: Role of hypotension in decreasing cerebral blood flow in porcine endotoxemia. Am J Physiol 253 (Heart Circ Physiol 22): H956-64, 1987.
Bowton DL, Berteis NH, Prough DS, Stump DA: Cerebral blood flow is reduced in patients with sepsis syndrome. Crit Care Med 17:399–403, 1989.
Maekawa T, Fujii Y, Sadamitsu D, et al: Cerebral circulation and metabolism in patients with septic encephalopathy. Am J Emerg Med 9:139–43, 1991.
Guyton AC: Textbook of Medical Physiology, 6th ed. Philadelphia, W. B. Saunders, 1981.
Zornow MH, Todd MM, Moore SS: The acute cerebral effects of changes in plasma osmolality and oncotic pressure. Anesthesiology 67:936–941, 1987.
Tommasino C, Moore S, Todd MM: Cerebral effects of isovolemic hemodilution with crystalloid or colloid solutions. Crit Care Med 16:862–868, 1988.
Prough DS, Johnson JC, Stump DA, Stullken EH, Poole GV Jr, Howard G: Effects of hypertonic saline versus lactated Ringer's solution on cerebral oxygen transport during resuscitation from hemorrhagic shock. J Neurosurg 64:627–632, 1986.
Todd MM, Weeks JB, Warner DS: Cerebral blod flow, blood volume, and brain tissue hematocrit during isovolemic hemodilution with hetastarch in rats. Am J Physiol 263 (Heart Circ Physiol 32):H75-82, 1992.
Michenfelder JD, Theye RA: The effects of profound hypocapnia and dilutional anemia on canine cerebral metabolism and blood flow. Anesthesiology 31:449–57, 1969.
Poole GV Jr, Prough DS, Johnson JC, et al: Effects of resuscitation from hemorrhagic shock on cerebral hemodynamics in the presence of an intracranial mass. J Trauma 27:18–23, 1987.
Todd MM, Tommasino C, Moore S: Cerebral effects of isovolemic hemodilution with a hypertonic saline solution. J Neurosurg 63:944–948, 1985.
Prough DS, Johnson JC, Poole GV Jr, et al: Effects on intracranial pressure of resuscitation from hemorrhagic shock with hypertonic saline versus lactated Ringer's solution. Crit Care Med 13:407–411, 1985.
Zornow MH, Scheller MS, Shackford SR: Effect of a hypertonic lactated Ringer's solution on intracranial pressure and cerebral water content in a model of traumatic brain injury. J Trauma 29:484–488, 1989.
Gunnar W, Jonasson O, Merlotti G, et al: Head injury and hemorrhagic shock: studies of the blood-brain barrier and intracranial pressure after resuscitation with normal saline solution, 3% saline solution, and dextran-40. Surgery 103:398–407, 1988.
Gunnar W, Kane J, Barrett J: Cerebral blood flow following hypertonic saline resuscitation in an experimental model of hemorrhagic shock and head injury. Braz J Med Biol Res 22:287–289, 1989.
Ducey JP, Mozingo DW, Lamiell JM, et ah A comparison of the cerebral and cardiovascular effects of complete resuscitation with isotonic and hypertonic saline, hetastarch, and whole blood following hemorrhage. J Trauma 29:1510–1518, 1989.
Prough DS, Whitley JM, Taylor CL, et al: Regional cerebral blood flow following resuscitation from hemorrhagic shock with hypertonic saline: influence of a subdural mass. Anesthesiology 75:319–327, 1991.
Gunnar WP, Merlotti GJ, Barrett J, Jonasson O: Resuscitation from hemorrhagic shock: alterations of the intracranial pressure after normal saline, 3% saline and dextran-40. Ann Surg 204:686–692, 1986.
De Witt DS, Prough DS, Taylor CL, Whitley JM: Reduced cerebral blood flow, oxygen delivery, and electrocephalographic activity after traumatic brain injury and mild hemorrhage in cats. J Neurosurg 76:812–21, 1992.
Prough DS, De Witt DS, Taylor CL, et al: Hypertonic saline does not reduce intracranial pressure or improve cerebral blood flow after experimental head injury and hemorrhage in cats. Anesthesiology 75:A544, 1991.
Shoemaker WC, Appel PL, Kram HB, et al: Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients. Chest 94:1176–1186, 1988.
Whitley JM, Prough DS, Brockschmidt JK, et al: Cerebral hemodynamic effects of fluid resuscitation in the presence of an experimental intracranial mass. Surgery 110:514–522, 1991.
Miller JD, Butterworth JF, Guideman SK, et al: Further experience in the management of severe head injury. J Neurosurg 54:289–299, 1981.
Vassar MJ, Perry A, Gannaway WL, Holcroft JW: 7.5% sodium chloride/dextran for resuscitation of trauma patients undergoing helicopter transport. Arch Surg 126:1065–72, 1991.
Vassar MJ, Perry CA, Holcroft JW: Analysis of potential risks associated with 7.5% sodium chloride resuscitation of traumatic shock. Arch Surg 125:1309–1315, 1990.
Shackford SR, Sise MJ, Fridlund PH, et al: Hypertonic sodium lactate versus lactated Ringer's solution for intravenous fluid therapy in operations on the abdominal aorta. Surgery 94:41–51, 1983.
Norenberg MD, Leslie KO, Robertson AS: Association between rise in serum sodium and central pontine myelinolysis. Ann Neurol 11:128–135, 1982.
Laureno R: Central pontine myelinolysis following rapid correction of hyponatremia. Ann Neurol 13:232–242, 1983.
Norenberg MD, Papendick RE: Chronicity of hyponatremia as a factor in experimental myelinolysis. Ann Neurol 15:544–547, 1984.
Mazzoni MC, Borgstrom P, Arfors KE, Intaglietta M: The efficacy of iso-and hyperosmotic fluids as volume expanders in fixed-volume and uncontrolled hemorrhage. Ann Emerg Med 19:350–358, 1990.
Gross D, Landau EH, Klin B, Krausz MM: Treatment of uncontrolled hemorrhagic shock with hypertonic saline solution. Surg Gynecol Obstet 170:106–112, 1990.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1993 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
Prough, D.S., DeWitt, D.S. (1993). Cerebrovascular Responses to Shock During Resuscitation. In: Sperry, R.J., Johnson, J.O., Stanley, T.H. (eds) Anesthesia and the Central Nervous System. Developments in Critical Care Medicine and Anesthesiology, vol 28. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-1610-7_5
Download citation
DOI: https://doi.org/10.1007/978-94-011-1610-7_5
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-010-4701-2
Online ISBN: 978-94-011-1610-7
eBook Packages: Springer Book Archive