Effects of hypertonic saline and mannitol on cortical cerebral microcirculation in a rabbit craniotomy model

BMC Anesthesiology

Pavel Dostal³  Jitka Schreiberova³  Vlasta Dostalova³  Vlasta Dostalova³  Tomas Tyll⁴  Jiri Paral²  Islam Abdo³  Miroslav Cihlo¹  David Astapenko³  Zdenek Turek³ 

[1] Department of Neurosurgery, Charles University, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic

[2] Department of Military Surgery, Faculty of Military Health Sciences, Hradec Kralove, University of Defence, Brno, Czech Republic

[3] Department of Anesthesia and Intensive Care Medicine, Charles University, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic

[4] Department of Anesthesia and Intensive Care Medicine, Charles University, 1st Faculty of Medicine Prague, Military University Hospital Prague, Prague, Czech Republic

关键词: Osmotherapy;    Microcirculation;    Mannitol;    Hypertonic saline;    Brain;   

Others  :  1212223
DOI  :  10.1186/s12871-015-0067-z

 received in 2014-12-21, accepted in 2015-05-28,  发布年份 2015

【 摘 要 】

Background

Hyperosmolar solutions have been used in neurosurgery to modify brain bulk and prevent neurological deterioration. The aim of this animal study was to compare the short-term effects of equivolemic, equiosmolar solutions of mannitol and hypertonic saline (HTS) on cerebral cortical microcirculation in a rabbit craniotomy model.

Methods

Rabbits (weight, 2.0–3.0 kg) were anesthetized, ventilated mechanically, and subjected to a craniotomy. The animals were allocated randomly to receive a 3.75 ml/kg intravenous infusion of either 3.2 % HTS (group HTS, n = 8) or 20 % mannitol (group MTL, n = 8). Microcirculation in the cerebral cortex was evaluated using sidestream dark-field (SDF) imaging before and 20 min after the end of the 15-min HTS infusion. Global hemodynamic data were recorded, and blood samples for laboratory analysis were obtained at the time of SDF image recording.

Results

No differences in the microcirculatory parameters were observed between the groups before the use of osmotherapy. After osmotherapy, lower proportions of perfused small vessel density (P = 0.0474), perfused vessel density (P = 0.0457), and microvascular flow index (P = 0.0207) were observed in the MTL group compared with those in the HTS group.

Conclusions

Our findings suggest that an equivolemic, equiosmolar HTS solution better preserves perfusion of cortical brain microcirculation compared to MTL in a rabbit craniotomy model.

【 授权许可】

   
2015 Dostal et al.

【 图 表 】

Fig. 1.

Fig. 2.

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