Abstract:
PRIMARY OBJECTIVE:This study aimed to investigate the effect of intravenous saline administration on orthostatic hypotension (OH) during head up tilt (HUT) and the change in the renin-angiotensin-aldosterone system before and after HUT in patients with severe acquired brain injury (ABI). RESEARCH DESIGN:The study is designed as an observational study. METHODS AND PROCEDURES:Fourteen patients with ABI, low level of consciousness and OH were monitored before, during and after HUT with non-invasive beat-to-beat blood pressure measurement, and transcranial Doppler determination of middle cerebral artery blood flow velocity. Blood samples were collected before and after two HUT sessions separated by 1 hour and saline was administered in between. MAIN OUTCOMES AND RESULTS:Patients' ability to stand upright did not change after saline administration due to OH. The patients showed signs of reduced cerebral autoregulation at both HUT sessions. The patients had a significant lower level of renin and angiotensin II but not aldosterone. CONCLUSIONS:Patients with severe ABI and OH demonstrate no improvement in standing time with reduced plasma renin and angiotensin II after two HUT sessions and 1 hour fluid administration. Research focusing on the ability to retain fluid after bed rest is warranted.
journal_name
Brain Injjournal_title
Brain injuryauthors
Riberholt C,Olesen N,Hovind P,Mehlsen J,Petersen THdoi
10.1080/02699052.2017.1408144subject
Has Abstractpub_date
2018-01-01 00:00:00pages
252-256issue
2eissn
0269-9052issn
1362-301Xjournal_volume
32pub_type
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