Effects of pneumatic antishock trousers on canine intracranial pressure

The military antishock trouser (MAST) has become an accepted prehospital treatment modality for hypovolemic shock. Our interest in the effect of MAST on intracranial pressure (ICP) was aroused by the manufacturer's written warning that use of the device was contraindicated in patients with suspected head injury. This study was undertaken to determine the effect of MAST device inflation on intracranial pressure in dogs with normal and artificially elevated ICP in both normovolemic and hypovolemic states. The largest increase in hemodynamic parameters was seen in mean arterial pressure (MAP) in hypovolemic animals. Although the ICP did increase with MAST inflation, it never reached levels of clinical significance. Furthermore, the cerebral perfusion pressure (MAP--ICP) was calculated and shown to be improved in all groups when the MAST device was inflated. Data from this study support clinical use of the MAST garment in hypovolemic patients even in the presence of suspected head injury.