Abstract: ObjectiveTo compare the effects of normal saline (NS), 10% hydroxyethyl starch (HES) and hypertonic-hyperoncotic solution (HHS,7.5% NaCl/10% HES) on regional cerebral blood flow (rCBF), brain edema and blood-brain barrier (BBB) in a rat model of traumatic head injury (THI) complicate with hemorrhagic shock. Methods60 SD rats were randomized into 5 groups: sham group (n=12), model group (n=12), NS group (n=12), HES group (n=12) and HHS group (n=12). rCBF and mean arterial pressure (MAP) were determined before and after THI, hemorrhagic shock and resuscitation. Cerebral water content and Evans Blue (EB) content were assessed 3 h after resuscitation.ResultsMAP and rCBF were restored to baseline values immediately after resuscitation in all resuscitated group and began to decrease 15 min, 30 min or 45 min later, respectively(P<0.05). 3 h after resuscitation, the brain water content was higher in NS group than those in sham or HHS group(P<0.05). EB contents of injured hemispheres were higher in model and NS group than those in HES or HHS group(P<0.05). ConclusionSmall-volume resuscitation with HHS can restore MAP and rCBF, decrease brain edema and improve BBB in a rat model of THI complicate with hemorrhagic shock.

Key words: brain trauma, hemorrhagic shock, resuscitation, brain edema, cerebral blood flow, blood-brain barrier, rat