Abstract Objective To explore the application effect of different fluid resuscitation strategies in rats with severe craniocerebral injury combined with hemorrhagic shock.Methods A total of 100 experimental rats were randomly divided into Group Ⅰ,Group Ⅱ,Group Ⅲand Group Ⅳaccording to random number table method,with 25 cases in each groups.Group Ⅰwas given 10%hypertonic sodium chloride injection for liquid resuscitation with a target of 80 mmHg,Group Ⅱwas given 10% hypertonic sodium chloride injection for liquid resuscitation with a target of 60 mmHg,and Group Ⅲwas given 7.5% hypertonic sodium chloride injection with a target of 80 mmHg for liquid resuscitation,Group Ⅳwas treated with 7.5%hypertonic sodium chloride injection and liquid resuscitation with 60 mmHg target.Each group was treated with hypertonic sodium chloride injection with different concentration values through jugular vein slowly until the target value of resuscitation.The mean arterial pressure and cerebral perfusion pressure before and after model establishment and resuscitation were measured,and the indexes of central venous pressure (CVP),intracranial pressure (ICP),mean arterial pressure(MAP),cerebral perfusion pressure(CPP),arterial blood sodium concentration,plasma osmotic pressure,and brain tissue water content of rats before model establishment (T0),after model establishment (T1),20 minutes after resuscitation(T2),40 minutes after resuscitation (T3),1 hour after resuscitation (T4),2 hours after resuscitation (T5),3 hours after resuscitation (T6),and 4 hours after resuscitation (T7) were compared.Results The level of MAP in group Ⅳat T7 were higher than those in the other three groups,and the differences were statistically significant (P<0.05).There were no significant differences in the level of MAP among the four groups at T1-T6 (P>0.05);There were no statistically significant differences in the concentration of arterial blood sodium at T0 in each group (P>0.05).The concentration of arterial blood sodium at T7 in group Ⅳwere significantly lower than those in the other three groups (P<0.05).There were no statistically significant difference in the osmotic pressure between the each groups in each period (P>0.05).The water content of brain tissue in the injured hemisphere of group Ⅰ,Ⅱand Ⅲwere higher than those in the healthy hemisphere at T1,with statistically significant differences(P<0.05).The water content of brain tissue in group Ⅳat T7 were lower than those in the other three groups,with statistically significant differences (P<0.05).Conclusion The treatment of severe brain injury combined with hemorrhagic shock with small volume fluid resuscitation can better restore the circulating blood volume of brain tissue in rats,and has a better effect on improving neural function.
[Key words] Hemorrhagic shock;Severe craniocerebral injury;Liquid resuscitation;Central venous pressure;Intracranial pressure
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