title: Effects of hypertonic saline and mannitol on cortical cerebral microcirculation in a rabbit craniotomy model.
abstract: 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.
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Charles University, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic. pavel.dostal@fnhk.cz.
authors.forename: Pavel
authors.initials: P
authors.lastname: Dostal
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Charles University, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic. jitka.schreiberova@fnhk.cz.
authors.forename: Jitka
authors.initials: J
authors.lastname: Schreiberova
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Charles University, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic. vlasta.dostalova@fnhk.cz.
authors.forename: Vlasta
authors.initials: V
authors.lastname: Dostalova
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Charles University, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic. vlahado@seznam.cz.
authors.forename: Vlasta
authors.initials: V
authors.lastname: Dostalova
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Charles University, 1st Faculty of Medicine Prague, Military University Hospital Prague, Prague, Czech Republic. tomas.tyll@uvn.cz.
authors.forename: Tomas
authors.initials: T
authors.lastname: Tyll
authors.affiliation: Department of Military Surgery, Faculty of Military Health Sciences, Hradec Kralove, University of Defence, Brno, Czech Republic. jiri.paral@seznam.cz.
authors.forename: Jiri
authors.initials: J
authors.lastname: Paral
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Charles University, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic. islamsalehabdo@gmail.cz.
authors.forename: Islam
authors.initials: I
authors.lastname: Abdo
authors.affiliation: Department of Neurosurgery, Charles University, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic. miroslav.cihlo@fnhk.cz.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Cihlo
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Charles University, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic. david.astapenko@fnhk.cz.
authors.forename: David
authors.initials: D
authors.lastname: Astapenko
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Charles University, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic. zdenek.turek@fnhk.cz.
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Turek
mesh_terms: D000818:Animals; D002540:Cerebral Cortex / Q000098:blood supply / Q000187:drug effects; D002560:Cerebrovascular Circulation / Q000187:drug effects; D003399:Craniotomy / Q000379:methods*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D008297:Male; D008353:Mannitol / Q000494:pharmacology*; D008833:Microcirculation / Q000187:drug effects*; D011817:Rabbits; D012462:Saline Solution, Hypertonic / Q000494:pharmacology*
chemical_list: D012462:Saline Solution, Hypertonic; D008353:Mannitol