Ultrastructural changes following overhydration with irrigating fluids.
We studied ultrastructural alterations caused by intravenous infusion of 150 ml/kg of irrigating fluid containing mannitol and/or sorbitol in 15 rabbits. The osmolality of the solutions varied between 165 and 350 mosmol/kg. Specimens for electron microscopic examination were obtained from the kidney, brain and lung. Regardless of the choice of solute, the hypo-osmotic solutions caused damage to kidney and brain tissue by inducing marked interstitial and cellular oedema. No such changes were observed after administration of isosmotic irrigating fluid. We conclude that ultrastructural changes following overhydration with irrigating fluid vary with the osmolality of the solution but not with the choice of solute. Moreover, the consistent absence of tissue damage in the lungs suggests that the lung is not a primary target organ for the "TUR syndrome".
Zhang
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Department of Anaesthesiology, Stockholm Södra Hospital, Sweden.
Hahn
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D000818:Animals; D001921:Brain / Q000187:drug effects / Q000648:ultrastructure*; D004234:Diuretics, Osmotic / Q000008:administration & dosage / Q000009:adverse effects; D004487:Edema / Q000139:chemically induced / Q000473:pathology; D007038:Hypotonic Solutions / Q000008:administration & dosage / Q000009:adverse effects; D007262:Infusions, Intravenous; D007668:Kidney / Q000187:drug effects / Q000648:ultrastructure*; D008168:Lung / Q000187:drug effects / Q000648:ultrastructure*; D008297:Male; D008353:Mannitol / Q000008:administration & dosage / Q000009:adverse effects; D008854:Microscopy, Electron; D011817:Rabbits; D013012:Sorbitol / Q000008:administration & dosage / Q000009:adverse effects; D007507:Therapeutic Irrigation / Q000009:adverse effects*
D004234:Diuretics, Osmotic; D007038:Hypotonic Solutions; D008353:Mannitol; D013012:Sorbitol