Albumin or hetastarch improves neurological outcome and decreases volume of brain tissue necrosis but not brain edema following closed-head trauma in rats

Ilia Chorny, Ron Bsorai, Alan A. Artru, Danny Talmor, Vadim Benkoviz, Leonid Roytblat, Yoram Shapira

    Research output: Contribution to journalArticlepeer-review

    21 Scopus citations

    Abstract

    The present study examined whether hemodilution with 20% human serum albumin (HSA) or 10% hydroxyethyl starch (HES) improved the outcome from closed-head trauma (CHT) in rats. Rats anesthetized with halothane were given one of three hemodilution solutions (i.e., 20% HSA, 10% HES, or control [0.9% saline]) after CHT or sham surgery. CHT was delivered using a weight drop impact of 0.5 J onto the closed cranium. The hemodilution solution (volume = 1% of body weight) was given just after determining the neurological severity score (NSS) at 1 hour following CHT. The NSS was determined again at 24, 48, and 72 hours following CHT. At 72 hours, brains were removed, and brain edema and brain tissue necrosis volume were determined. Solutions of 20% HSA and 10% HES significantly improved brain tissue necrosis volume (143 ± 72 mm3 and 104 ± 53 mm3 as compared to 271 ± 65 mm3 in controls, mean ± SD) and NSS (12 ±2 and 9 ± 2 as compared to 15 ± 2 in controls at 72 hours, median ± range) but not brain edema. The hematocrit decreased similarly in all groups during hemodilution. Hemodilution with 20% HSA and 10% HES following CHT in rats did not decrease brain edema but did decrease brain tissue necrosis volume and NSS (improved neurological function), suggesting that the beneficial effect of hemodilution resulted not from decreased edema formation but rather from effects not measured in this study such as improved perfusion of the salvageable brain tissue surrounding the core injury.

    Original languageEnglish
    Pages (from-to)273-281
    Number of pages9
    JournalJournal of Neurosurgical Anesthesiology
    Volume11
    Issue number4
    DOIs
    StatePublished - 1 Jan 1999

    Keywords

    • Brain edema
    • Brain protection
    • Closed-head trauma
    • Hemodilution
    • Neurological outcome
    • Rat

    ASJC Scopus subject areas

    • Surgery
    • Clinical Neurology
    • Anesthesiology and Pain Medicine

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