Effects of Hypertonic Saline and Sodium Lactate on Cortical Cerebral Microcirculation and Brain Tissue Oxygenation.
BACKGROUND
Hyperosmolar solutions have been used in neurosurgery to modify brain bulk. The aim of this animal study was to compare the short-term effects of equivolemic, equiosmolar solutions of hypertonic saline (HTS) and sodium lactate (HTL) on cerebral cortical microcirculation and brain tissue oxygenation in a rabbit craniotomy model.


METHODS
Rabbits (weight, 1.5 to 2.0 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=9), half-molar sodium lactate (group HTL, n=10), or normal saline (group C, n=9). Brain tissue partial pressure of oxygen (PbtO2) and microcirculation in the cerebral cortex using sidestream dark-field imaging were evaluated before, 20 and 40 minutes after 15 minutes of hyperosmolar solution infusion. Global hemodynamic data were recorded, and blood samples for laboratory analysis were obtained at the time of sidestream dark-field image recording.


RESULTS
No differences in the microcirculatory parameters were observed between the groups before and after the use of osmotherapy. Brain tissue oxygen deteriorated over time in groups C and HTL, this deterioration was not significant in the group HTS.


CONCLUSIONS
Our findings suggest that equivolemic, equiosmolar HTS and HTL solutions equally preserve perfusion of cortical brain microcirculation in a rabbit craniotomy model. The use of HTS was better in preventing the worsening of brain tissue oxygen tension.
Departments of Anesthesia and Intensive Care Medicine.
Vlasta
V
Dostalova
Departments of Anesthesia and Intensive Care Medicine.
Jitka
J
Schreiberova
Departments of Anesthesia and Intensive Care Medicine.
Vlasta
V
Dostalova
Department of Military Surgery, Faculty of Military Health Sciences, Hradec Kralove, University of Defence, Brno, Czech Republic.
Jiri
J
Paral
Departments of Anesthesia and Intensive Care Medicine.
Jaroslav
J
Kraus
Clinical Biochemistry, Charles University, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove.
Alena
A
Ticha
Department of Military Surgery, Faculty of Military Health Sciences, Hradec Kralove, University of Defence, Brno, Czech Republic.
Vera
V
Radochova
Departments of Anesthesia and Intensive Care Medicine.
Pavel
P
Dostal
D000758:Anesthesia; D000818:Animals; D001923:Brain Chemistry / Q000187:drug effects*; D002540:Cerebral Cortex / Q000098:blood supply* / Q000187:drug effects*; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D003399:Craniotomy; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D008297:Male; D008833:Microcirculation / Q000187:drug effects*; D023421:Models, Animal; D009994:Osmolar Concentration; D010101:Oxygen Consumption / Q000187:drug effects*; D011817:Rabbits; D012462:Saline Solution, Hypertonic / Q000494:pharmacology*; D019354:Sodium Lactate / Q000494:pharmacology*
D012462:Saline Solution, Hypertonic; D019354:Sodium Lactate