{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T22:48:44Z","timestamp":1778712524432,"version":"3.51.4"},"reference-count":58,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2006,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Limited resuscitation following uncontrolled hemorrhagic shock (HS) has been associated with improved outcomes in various animal models, although it has not been previously studied in the setting of traumatic brain injury (TBI) and ethanol intoxication. The aim of the present study was to determine the effects of ethanol intoxication in a model of experimental TBI and HS treated with limited resuscitation.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>After induction of anesthesia and the placement of instruments, swine were subjected to a fluid-percussion injury of 3 atm. Simultaneously, hemorrhage was induced from an arterial catheter via a computerized roller pump to a mean arterial blood pressure (MABP) of 50 mm Hg, at which time uncontrolled hemorrhage was induced by the creation of an aortic tear. When the MABP decreased to 30 mm Hg, limited resuscitation to a MABP of 60 mm Hg was begun. After 60 minutes, animals were aggressively resuscitated to baseline MABP levels. Two groups of animals were studied: those receiving tap water by gastrostomy tube and those receiving ethanol (4 g\/kg) by gastrostomy tube. Animals were monitored for 180 minutes after TBI. Hemorrhage volumes were significantly greater in ethanol-infused animals (mean \u00b1 standard deviation, 41 \u00b1 34 mm Hg) compared with tap water\u2013infused animals (17 \u00b1 18 mm Hg; p = 0.048). Resuscitation requirements were significantly higher and metabolic parameters significantly worse in the ethanol group. Survival time was also significantly decreased in the animals infused with ethanol (81 \u00b1 60 minutes) compared with those infused with tap water (130 \u00b1 51 minutes; p = 0.035).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Ethanol intoxication led to increased hemorrhage volume and worsened hemodynamic and metabolic profiles in this model of limited resuscitation after TBI and HS. Ethanol-exposed animals had increased resuscitation requirements and decreased survival times.<\/jats:p><\/jats:sec>","DOI":"10.3171\/jns.2006.105.6.884","type":"journal-article","created":{"date-parts":[[2008,1,24]],"date-time":"2008-01-24T12:41:37Z","timestamp":1201178497000},"page":"884-893","source":"Crossref","is-referenced-by-count":9,"title":["Effects of ethanol on limited resuscitation in a model of traumatic brain injury and hemorrhagic shock"],"prefix":"10.3171","volume":"105","author":[{"given":"Brian J.","family":"Zink","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan; and Department of Emergency Medicine, Regions Hospital, University of Minnesota, St. Paul, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan A.","family":"Stern","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan; and Department of Emergency Medicine, Regions Hospital, University of Minnesota, St. Paul, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian D.","family":"McBeth","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan; and Department of Emergency Medicine, Regions Hospital, University of Minnesota, St. Paul, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan; and Department of Emergency Medicine, Regions Hospital, University of Minnesota, St. Paul, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Mertz","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan; and Department of Emergency Medicine, Regions Hospital, University of Minnesota, St. Paul, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-1050884","series-title":"MMWR Surveill Summ","first-page":"1","article-title":"Surveillance for traumatic brain injury deaths\u2014United States, 1989\u20131998","volume":"51","year":"2002"},{"key":"b2-1050884","series-title":"J Neurotrauma","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1089\/089771504774129900","article-title":"The effects of admission alcohol level on cerebral blood flow and outcomes after severe traumatic brain injury","volume":"21","year":"2004"},{"key":"b3-1050884","series-title":"Alcohol","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1016\/0741-8329(84)90056-9","article-title":"Alcohol, the cerebral circulation and strokes","volume":"1","year":"1984"},{"key":"b4-1050884","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1246","DOI":"10.1161\/01.STR.0000068170.80517.B3","article-title":"Ethanol plus caffeine (caffeinol) for treatment of ischemic stroke: preclinical experience","volume":"34","year":"2003"},{"key":"b5-1050884","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1056\/NEJM199410273311701","article-title":"Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries","volume":"331","year":"1994"},{"key":"b6-1050884","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"360","DOI":"10.3171\/jns.1992.77.3.0360","article-title":"Ultraearly evaluation of regional cerebral blood flow in severely head-injured patients using xenon-enhanced computerized tomography","volume":"77","year":"1992"},{"key":"b7-1050884","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"685","DOI":"10.3171\/jns.1991.75.5.0685","article-title":"Cerebral circulation and metabolism after severe traumatic brain injury: the elusive role of ischemia","volume":"75","year":"1991"},{"key":"b8-1050884","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1097\/00006123-199304000-00009","article-title":"Multimodality monitoring as a guide to treatment of intracranial hypertension after severe brain injury","volume":"32","year":"1993"},{"key":"b9-1050884","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"55","DOI":"10.3171\/jns.1992.77.1.0055","article-title":"The effect of changes in cerebral perfusion pressure upon middle cerebral artery blood flow velocity and jugular bulb venous oxygen saturation after severe brain injury","volume":"77","year":"1992"},{"key":"b10-1050884","series-title":"J Trauma","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1097\/00005373-199806000-00003","article-title":"Neurogenic hypotension in patients with severe head injury","volume":"44","year":"1998"},{"key":"b11-1050884","series-title":"J Trauma","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1097\/00005373-199302000-00006","article-title":"The role of secondary brain injury in determining outcome from severe head injury","volume":"34","year":"1993"},{"key":"b12-1050884","series-title":"J Neurotrauma","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.1089\/neu.2004.21.1573","article-title":"Post-trauma administration of caffeine plus ethanol reduces contusion volume and improves working memory in rats","volume":"21","year":"2004"},{"key":"b13-1050884","series-title":"Ann Emerg Med","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1016\/S0196-0644(05)82740-4","article-title":"Clinical considerations in the reduction of secondary brain injury","volume":"22","year":"1993"},{"key":"b14-1050884","series-title":"Alcohol","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/S0741-8329(97)00102-X","article-title":"Alcohol-induced vascular damage of brain is ameliorated by administration of magnesium","volume":"15","year":"1998"},{"key":"b15-1050884","series-title":"J Invest Surg","doi-asserted-by":"publisher","first-page":"117","DOI":"10.3109\/08941939309141603","article-title":"Brain injury causes loss of cardiovascular response to hemorrhagic shock","volume":"6","year":"1993"},{"key":"b16-1050884","series-title":"J Neurotrauma","first-page":"125","article-title":"Assessment: oxygenation and blood pressure","volume":"19","year":"2000"},{"key":"b17-1050884","series-title":"J Neurotrauma","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1089\/089771502753594882","article-title":"Acute ethanol intake attenuates inflammatory cytokines after brain injury in rats: a possible role for corticosterone","volume":"19","year":"2002"},{"key":"b18-1050884","series-title":"Anesthesiology","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1097\/00000542-198511000-00011","article-title":"Isoflurane for neuroanesthesia: risk factors for increases in intracranial pressure","volume":"63","year":"1985"},{"key":"b19-1050884","series-title":"J Trauma","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1097\/00005373-199211000-00020","article-title":"The effects of alcohol intoxication on the initial treatment and hospital course of patients with acute brain injury","volume":"33","year":"1992"},{"key":"b20-1050884","series-title":"Domestic Swine in Physiological Research. A Biomedical Model","year":"1981"},{"key":"b21-1050884","series-title":"Injury","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/0020-1383(91)90047-I","article-title":"Impact of acute alcohol intoxication on patterns of non-fatal trauma: cause-specific analysis of head injury effect","volume":"22","year":"1991"},{"issue":"1 Suppl","key":"b22-1050884","series-title":"J Neurotrauma","first-page":"S47","article-title":"Secondary injury and acidosis","volume":"9","year":"1992"},{"key":"b23-1050884","series-title":"J Trauma","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1097\/00005373-199209000-00003","article-title":"Improved outcome with hypotensive resuscitation of uncontrolled hemorrhagic shock in a swine model","volume":"33","year":"1992"},{"key":"b24-1050884","series-title":"Am J Public Health","doi-asserted-by":"publisher","first-page":"294","DOI":"10.2105\/AJPH.79.3.294","article-title":"Blood alcohol tests, prevalence of involvement, and outcomes following brain injury","volume":"79","year":"1989"},{"key":"b25-1050884","series-title":"Am J Cardiol","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/S0002-9149(00)01277-7","article-title":"Acute and delayed antithrombotic effects of alcohol in humans","volume":"87","year":"2001"},{"key":"b26-1050884","series-title":"Neurosci Lett","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/j.neulet.2003.10.047","article-title":"Alcohol-induced apoptosis of canine cerebral vascular smooth muscle cells: role of extracellular and intracellular calcium ions","volume":"354","year":"2004"},{"key":"b27-1050884","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"407","DOI":"10.3171\/jns.1991.74.3.0407","article-title":"Acute regional cerebral blood flow changes caused by severe head injuries","volume":"74","year":"1991"},{"issue":"Suppl","key":"b28-1050884","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"S59","DOI":"10.3171\/sup.1991.75.1s.0s59","article-title":"Impact of ICP instability and hypotension on outcome in patients with severe head trauma","volume":"75","year":"1991"},{"key":"b29-1050884","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1001\/jama.1978.03290050029011","article-title":"Early insults to the injured brain","volume":"240","year":"1978"},{"key":"b30-1050884","series-title":"Anesth Analg","first-page":"898","article-title":"Effects of isoflurane, fentanyl, or thiopental anesthesia on regional cerebral blood flow and brain surface PO2 in the presence of a focal lesion in rabbits","volume":"77","year":"1993"},{"key":"b31-1050884","series-title":"Eur J Clin Invest","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1111\/j.1365-2362.1993.tb00759.x","article-title":"Cerebral trauma and alcohol abuse","volume":"23","year":"1993"},{"key":"b32-1050884","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"949","DOI":"10.3171\/jns.1995.83.6.0949","article-title":"Cerebral perfusion pressure: management protocol and clinical results","volume":"83","year":"1995"},{"key":"b33-1050884","series-title":"Alcohol Clin Exp Res","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1111\/j.1530-0277.1999.tb04234.x","article-title":"Effect of ethanol on platelet function","volume":"23","year":"1999"},{"key":"b34-1050884","series-title":"Anesthesiology","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1097\/00000542-198710000-00011","article-title":"The intracranial pressure effects of isoflurane and halothane administered following cryogenic brain injury in rabbits","volume":"67","year":"1987"},{"key":"b35-1050884","series-title":"J Trauma","doi-asserted-by":"publisher","first-page":"1392","DOI":"10.1097\/00005373-198910000-00018","article-title":"Epidemiology and pathology of traumatic deaths occurring at a Level I Trauma Center in a regionalized system: the importance of secondary brain injury","volume":"29","year":"1989"},{"key":"b36-1050884","series-title":"Crit Care Med","doi-asserted-by":"publisher","first-page":"1252","DOI":"10.1097\/00003246-199110000-00007","article-title":"Effect of associated injuries and blood volume replacement on death, rehabilitation needs, and disability in blunt traumatic brain injury","volume":"19","year":"1991"},{"key":"b37-1050884","series-title":"Acad Emerg Med","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1197\/j.aem.2005.07.016","article-title":"The effect of ethanol on uncontrolled hemorrhage in a rodent model","volume":"12","year":"2005"},{"key":"b38-1050884","series-title":"Ann Emerg Med","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/S0196-0644(05)80195-7","article-title":"Effect of blood pressure on hemorrhage volume and survival in a near-fatal hemorrhage model incorporating a vascular injury","volume":"22","year":"1993"},{"key":"b39-1050884","series-title":"Acad Emerg Med","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1111\/j.1553-2712.1995.tb03167.x","article-title":"Multiple resuscitation regimens in a near-fatal porcine aortic injury hemorrhage model","volume":"2","year":"1995"},{"key":"b40-1050884","series-title":"Shock","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1097\/00024382-200115010-00003","article-title":"Under-resuscitation of near-lethal uncontrolled hemorrhage: effects on mortality and end-organ function at 72 hours","volume":"15","year":"2001"},{"key":"b41-1050884","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"305","DOI":"10.3171\/jns.2000.93.2.0305","article-title":"Effect of initially limited resuscitation in a combined model of fluid-percussion brain injury and severe uncontrolled hemorrhagic shock","volume":"93","year":"2000"},{"key":"b42-1050884","series-title":"Neuropharmacology","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1016\/S0028-3908(99)00156-2","article-title":"Combination of low dose ethanol and caffeine protects brain from damage produced by focal ischemia in rats","volume":"39","year":"2000"},{"key":"b43-1050884","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1001\/jama.282.10.954","article-title":"Trends in hospitalization associated with traumatic brain injury","volume":"282","year":"1999"},{"key":"b44-1050884","series-title":"Traumatic Brain Injury in the United States: a Report to Congress","year":"1999"},{"key":"b45-1050884","series-title":"J Head Trauma Rehabil","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1097\/00001199-199912000-00009","article-title":"Traumatic brain injury in the United States: A public health perspective","volume":"14","year":"1999"},{"key":"b46-1050884","series-title":"Neurol Res","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1179\/016164104773026633","article-title":"Acute ethanol intoxication in a model of traumatic brain injury: the protective role of moderate doses demonstrated by immunoreactivity of synaptophysin in hippocampal neurons","volume":"26","year":"2004"},{"key":"b47-1050884","series-title":"J Trauma","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1097\/00005373-199303000-00012","article-title":"The effect of secondary insults on mortality and long-term disability of severe head injury in a rural region without a trauma system","volume":"34","year":"1993"},{"key":"b48-1050884","series-title":"Circ Shock","first-page":"231","article-title":"Influences of traumatic brain injury on the outcomes of delayed and repeated hemorrhages","volume":"35","year":"1991"},{"key":"b49-1050884","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"408","DOI":"10.3171\/jns.1991.75.3.0408","article-title":"Suppression by traumatic brain injury of spontaneous hemodynamic recovery from hemorrhagic shock in rats","volume":"75","year":"1991"},{"key":"b50-1050884","series-title":"Alcohol Clin Exp Res","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1111\/j.1530-0277.2000.tb02021.x","article-title":"Effects of acute, moderate ethanol consumption on human platelet aggregation in platelet-rich plasma and whole blood","volume":"24","year":"2000"},{"key":"b51-1050884","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"822","DOI":"10.3171\/jns.1995.82.5.0822","article-title":"Effects of ethanol on respiratory function in traumatic brain injury","volume":"82","year":"1995"},{"key":"b52-1050884","series-title":"Alcohol Clin Exp Res","doi-asserted-by":"publisher","first-page":"1518","DOI":"10.1111\/j.1530-0277.1996.tb01693.x","article-title":"Alcohol, central nervous system injury, and time to death in fatal motor vehicle crashes","volume":"20","year":"1996"},{"key":"b53-1050884","series-title":"Alcohol Clin Exp Res","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1111\/j.1530-0277.2001.tb02298.x","article-title":"Effects of ethanol and naltrexone in a model of traumatic brain injury with hemorrhagic shock","volume":"25","year":"2001"},{"key":"b54-1050884","series-title":"Brain Res","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/S0006-8993(99)01646-7","article-title":"Effects of ethanol on brain lactate in experimental traumatic brain injury with hemorrhagic shock","volume":"837","year":"1999"},{"key":"b55-1050884","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"983","DOI":"10.3171\/jns.1998.89.6.0983","article-title":"Acute ethanol intoxication in a model of traumatic brain injury with hemorrhagic shock: effects on early physiological response","volume":"89","year":"1998"},{"key":"b56-1050884","series-title":"Acad Emerg Med","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1111\/j.1553-2712.1998.tb02568.x","article-title":"Effects of ethanol in an experimental model of combined traumatic brain injury and hemorrhagic shock","volume":"5","year":"1998"},{"key":"b57-1050884","series-title":"Ann Emerg Med","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/S0196-0644(88)80496-7","article-title":"The effect of ethanol on survival time in hemorrhagic shock in an unanesthetized swine model","volume":"17","year":"1988"},{"key":"b58-1050884","series-title":"J Neurotrauma","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1089\/neu.1993.10.275","article-title":"Effects of ethanol in traumatic brain injury","volume":"10","year":"1993"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/105\/6\/article-p884.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/105\/6\/article-p884.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/105\/6\/article-p884.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,9]],"date-time":"2024-03-09T09:47:14Z","timestamp":1709977634000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/105\/6\/article-p884.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,12]]},"references-count":58,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/jns.2006.105.6.884","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[2006,12]]}}}