title: Effects of different liquid therapies on brain water content, intracranial pressure, and expressions of aquaporin-4 and N-methyl-D-aspartate receptor-1 in cerebral tissue.
abstract: OBJECTIVE
  To explore the effects of different liquid therapies on the intracranial pressure, brain water content, and expressions of aquaporin-4 and N-methyl-D-aspartate-1 in the brain tissue.
  
  
  METHODS
  Two intervention factors including the colloids (two levels: 4% gelofusine; 6% hydroxyethyl starch and sodium chloride injection) and the crystal/gel ratios (two levels: 0:1; 1:1) were set based on the results of the analysis of variance of factorial design. Thirty-two patient who had undergone epilepsy surgery were equally and randomly divided into four groups: group A (4% gelofusine, crystal/gel ratio 0:1); group B (6% hydroxyethyl starch and sodium chloride injection, crystal/gel ratio 0:1); group C (4% gelofusine, crystal/gel ratio 1:1); and group D (6% hydroxyethyl starch and sodium chloride injection, crystal/gel ratio 1:1). The intracranial pressure during operation was recorded. After the operation, the intracranial pressure and brain water content were measured and the expressions of aquaporin-4 and N-methyl-D-aspartate-1 in the brain tissue were determined with Western blot. Glasgow coma scores were obtained 2 hours after operation.
  
  
  RESULTS
  The intracranial pressure (F=55.714, P=0.000; F=142.432, P=0.000) and the brain water content (F=31.477, P=0.000; F=84.896, P=0.000) significantly increased after the application of the 6% hydroxyethyl starch and sodium chloride injection and crystal/gel ratio 1:1, and the expressions of aquaporin-4 (F=37.205, P=0.000; F=149.652, P=0.014) and N-methyl-D-aspartate-1(F=29.664, P=0.000; F=65.951, P=0.000) in the brain tissue significantly increased. There were additive effects between two of them (the intracranial pressure: F=11.056, P=0.002; the brain water content: F=8.007, P=0.008; the expression of aquaporin-4: F=9.845, P=0.004; and the expression of N-methyl-D-aspartate-1: F=5.020, P=0.033). However, the Glasgow coma score showed no significant difference after the administration (P>0.05).
  
  
  CONCLUSIONS
  The liquid therapy with 4% gelofusine and crystal/gel ratio 0:1 can result in better control on the intracranial pressure, brain water content and expressions of aquaporin-4 and N-methyl-D-aspartate-1 in the brain tissue better than the liquid therapy with 6% hydroxyethyl starch and crystal/gel ratio 1:1 during neurosurgery, although it may not improve the coma status.
authors.affiliation: Department of Emergency, Tianjin Union Medicine Centre, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Wang
authors.forename: Chao
authors.initials: C
authors.lastname: Liu
authors.forename: Xue-ning
authors.initials: XN
authors.lastname: Zhang
authors.forename: Min
authors.initials: M
authors.lastname: Su
authors.forename: Dong
authors.initials: D
authors.lastname: Liu
authors.forename: Ke
authors.initials: K
authors.lastname: Wei
authors.forename: Jun
authors.initials: J
authors.lastname: Dong
authors.forename: Jie
authors.initials: J
authors.lastname: Luo
authors.forename: Xiao-bin
authors.initials: XB
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D051401:Aquaporin 4 / Q000378:metabolism*; D001921:Brain / Q000187:drug effects / Q000378:metabolism*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007427:Intracranial Pressure / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D016202:N-Methylaspartate / Q000378:metabolism*; D014867:Water / Q000378:metabolism; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D014867:Water; D016202:N-Methylaspartate