Hypertonic/hyperoncotic saline attenuates microcirculatory disturbances after traumatic brain injury

J Trauma. 1997 May;42(5 Suppl):S41-7. doi: 10.1097/00005373-199705001-00008.


Background: Traumatic brain injury (TBI) induces an acute inflammatory response characterized by early recruitment of inflammatory cells (white blood cells). Rapid resuscitation of TBI with hypertonic saline/dextran (HS/DEX) yields promising results in clinical and experimental studies. The purpose of this paper was to test the hypothesis that HS/DEX exerts its effects in part through a modulation of the acute inflammatory response to TBI.

Methods: Rabbits equipped with chronic cranial windows underwent fluid-percussion injury and were followed up for 6 hours. Intravital fluorescence videomicroscopy technique was used to visualize white blood cell trafficking and to measure pia vessel diameters and venular shear rates. Three groups were studied: sham (group I, n = 5), trauma (group II, n = 7), and trauma and 4 mL/kg 7.2% NaCl/10% dextran 60 IV over 5 minutes at 10 minutes after TBI (group III, n = 7).

Results: TBI in groups II and III led to significant increases of intracranial pressure. Arteriolar diameters after trauma increased by 17 +/- 8% at 6 hours in group II. Infusion of HS/DEX completely prevented this secondary diameters increase. At 6 hours, the increase of "sticking" white blood cells in group III was reduced by approximately 90% compared with group II.

Conclusions: Whether the anti-inflammatory effect of HS/DEX plays a role in reducing delayed brain damage (> 6 hours after TBI) or other systemic complications of TBI arises as an important question and should be investigated further.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Animals
  • Brain Injuries / immunology
  • Brain Injuries / physiopathology*
  • Brain Injuries / therapy*
  • Cerebrovascular Circulation / drug effects*
  • Child, Preschool
  • Dextrans / therapeutic use*
  • Disease Models, Animal
  • Drug Combinations
  • Drug Evaluation, Preclinical
  • Humans
  • Inflammation
  • Leukocytes / immunology
  • Microcirculation / drug effects*
  • Plasma Substitutes / therapeutic use*
  • Rabbits
  • Saline Solution, Hypertonic / therapeutic use*
  • Time Factors


  • Dextrans
  • Drug Combinations
  • Plasma Substitutes
  • Saline Solution, Hypertonic