Hypertonic saline (7.2%) in 6% hydroxyethyl starch reduces intracranial pressure and improves hemodynamics in a placebo-controlled study involving stable patients with subarachnoid hemorrhage*

Abstract

In this placebo-controlled study involving spontaneous subarachnoid hemorrhage patients with normal to moderately increased ICP, 2 mL/kg HSS reduced ICP and increased cerebral perfusion pressure significantly. Maximum effect was reached at twice the infusion time of 30 mins. There were also beneficial hemodynamic effects with increased cardiac index in the HSS group.

Brain death and its implications for management of the potential organ donor

“…When a potential organ donor eventually becomes an actual donor, this brain-saving therapy might have some consequences for organ quality and donor management. The therapy often includes hydroxyethyl starch (HES), 69 which can induce injury to renal tubular cells and impair early renal graft function. 71,72 Such treatment often results in hypernatremia, which is associated with an increased risk of graft dysfunction after liver transplantation.…”

“…This treatment often includes heavy sedation and infusions of hyperoncotic solutions with high levels of saline to reduce ICP and to improve cerebral hemodynamics. 69,70 Heavy sedation often demands infusion of catecholamines to restore cardiac output (CO) and achieve a targeted cerebral perfusion pressure. When a potential organ donor eventually becomes an actual donor, this brain-saving therapy might have some consequences for organ quality and donor management.…”

Вплив Волемічної Підтримки Збалансованим Кристалоїдним Розчином На Предиктори Розвитку Ниркового Пошкодження В Постраждалих Із Тяжкою Черепно-Мозковою Травмою

“…У пе-реважній більшості випадків пацієнти з пригнічен-ням свідомості до сопору та коми при надходженні у відділення інтенсивної терапії перебувають у ста-ні гіповолемії. У більшості пацієнтів з ізольованою ЧМТ артеріальний тиск (АТ) у перші години піс-ля травми, як правило, підвищений, незважаючи на існуючий дефіцит об'єму циркулюючої крові, що становить приблизно 25-30 % [2]. Саме тому…”

Hypertonic Saline and Mannitol Therapy in Critical Care Neurology

“…Additionally, the authors hypothesize that SAH patients might be more suitable for the osmotic effect of HS given a relatively intact blood-brain barrier. 49 Cerebral blood flow was of particular interest to Tseng et al Their group showed that infusions of 23.5% HS not only reduced ICP but also increased CBF as evidenced by continuous transcranial dopplar and Xenon-enhanced computed tomography scans. Patients with the greatest increases in CBF in response to HS seemed to also have the most favorable outcomes as measured by discharge modified Rankin scores.…”