Efeitos da hemodiluição normovolêmica aguda com Ringer lactato e hidroxietilamido na hipertensão intracraniana: estudo em cães com lesão criogênica do cérebro / Effects of acute normovolemic hemodilution with lactated Ringers solution and hydroxyethylstarch in intracranial hypertension: study in dogs with cryogenic brain injury

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

Objective: Brain injury is responsible for significant morbidity and mortality in trauma patients, but controversy still exists over optimal fluid management for these patients. This study aimed to investigate the effects of acute hemodilution with hydroxyethyl starch (HES) or lactated Ringers solution (LR) in intracranial pressure(ICP) and cerebral perfusion pressure in dogs submitted to a cryogenic brain injury model. Design: Prospective laboratory animal study. Setting: Research laboratory in a teaching hospital. Subjects: Thirty-five male mongrel dogs. Interventions: Animals were enrolled to 5 groups: control, hemodilution with lactated Ringers solution (RL) or hydroxyethyl starch (HES) 6% to an hematocrit target of 27% or 35%. Measurements and Main Results: ICP and CPP levels were measured after cryogenic brain injury. Hemodilution promotes an increment of ICP levels, which decreases CPP when hematocrit target was estimated in 27% after hemodilution. However, no differences were observed regarding crystalloid or colloid solution used for hemodilution in ICP and CPP levels. Conclusions: Hemodilution to a low hematocrit level increases ICP and decreases CPP scores in dogs submitted to a cryogenic brain injury. These results suggest that excessive hemodilution to a hematocrit below 30% should be avoided in traumatic brain injury patients.

ASSUNTO(S)

hemodiluição cães hetastarch brain injuries/therapy traumatismos encefálicos/terapia dogs hemodilution brain injuries/blood hetamido traumatismos encefálicos/sangue

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