Comparison between Hypertonic Saline with Dextran and Mannitol on Vasodilatation of Encephalic Vessels Using a Magnetic Resonance Imaging in the Dogs

Miki Akaishizawa, Reiko Tabata, Kazuyuki Suzuki, Ryuji Asano

.

DOI: 10.4236/ojvm.2011.11001                

Abstract

This study aimed to investigate whether a small volume of 7.2% hypertonic saline solution with 6% dextran 70 (HSD) is superior to mannitol in vasodilatation of encephalic vessels in the dogs using magnetic resonance imaging (MRI). Fifteen healthy 2.4 ± 0.9 year-old purpose-bred male Beagle dogs were assigned to receive 5 mL/kg of isotonic saline solution (ISS) as control, 20% mannitol or HSD infusion at a flow rate of 20 mL/kg/hours via right cephalic vein.Venous blood samples were collected immediately before fluid infusion (pre) and every 15 minutes until 120 minutes after the initiation of fluid infusion. Immediately after collection of each blood sample, T1 and T2-weighted magnetic resonance imaging recordings were undergone. Immediately after HSD infusion, the area of the cross-section of superior sagittal sinus was significantly greater than that of beagles in the other groups (p < 0.001), reaching the 2.09 ± 0.25 times prevalue. During the 120 minutes period of observation after the initiation of fluid infusion, HSD infusion significantly reduced the area of the cross-section of CSF compared with the mannitol group ((p < 0.001). Our results indicate that HSD induced a rapid and strong reduction in the area of the cross-section of CSF more than mannitol did. Therefore, it is suggested that 5 mL/kg of HSD might be superior to isovolume of mannitol in inducing vasodilatation in the dog.

Keywords

Canine, Hypertonic Saline, Magnetic Resonance Imaging, Mannitol, Superior Sagittal Sinus

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	T. Arai, I. Tsukahara, K. Nitta and T. Watanabe, “Effects of Mannitol on Cerebral Circulation after Transient Complete Cerebral Ischemia in Dog,” Critical Care Medicine, Vol. 14, No. 7, 1986, pp. 634-637. doi:10.1097/00003246-198607000-00010
[2]	A. D. Mendelow, G. M. Teasdale, T. Russell, J. Flood, J. Patterson and G. D. Murray, “Effect of Mannitol on Cerebral Blood Flow and Cerebral Perfusion Pressure in Human Head Injury,” Journal of Neurosurgery, Vol. 63, No. 1, 1985, pp. 43-48. doi:10.3171/jns.1985.63.1.0043
[3]	S. P. Freshman, F. D. Battistella, M. Matteucci and D. H. Wisner, “Hypertonic Saline (7.5%) Versus Mannitol: A Comparison for Treatment of Acute Head Injuries,” Journal of Trauma, Vol. 35, No. 3, 1993, pp. 344-348. doi:10.1097/00005373-199309000-00003
[4]	F. Nath and S. Galbraith, “The Effect of Mannitol on Cerebral White Matter Water Content,” Journal of Neurosurgery, Vol. 65, No. 1, 1986, pp. 41-43. doi:10.3171/jns.1986.65.1.0041
[5]	H. P. Smith, D. L. Kelly, J. M. McWhorter, D. Armstrong, R. Johnson, C. Transou and G. Howard, “Comparison of Mannitol Regimens in Patients with Severe Head Injury Undergoing Intracranial Monitoring,” Journal of Neurosurgery, Vol. 65, No. 6, 1986, pp. 820-824. doi:10.3171/jns.1986.65.6.0820
[6]	A. M. Kaufmann and E. R. Cardoso, “Aggravation of Vasogenic Edema by Multiple-Dose Mannitol,” Journal of Neurosurgery, Vol. 72, No. 4, 1992, pp. 584-589. doi:10.3171/jns.1992.77.4.0584
[7]	S. Berger, L. Schurer, R. Hartl, K. Messmer and A. Baethmann, “Reduction of Post-Traumatic Intracranial Hypertension by Hypertonic/Hyperoncotic Saline/Dextran and Hypertonic Mannitol,” Neurosurgery, Vol. 37, No. 1, 1995, pp. 98-108. doi:10.1227/00006123-199507000-00015
[8]	O. Chiara, P. Pelosi, L. Brazzi, N. Bottino, P. Taccone, S. Cimbanassi, M. Segala, L. Gattinoni and T. Scalea. “Resuscitation from Hemorrhagic Shock: Experimental Model Comparing Normal Saline, Dextran, and Hypertonic Saline Solutions,” Critical Care Medicine, Vol. 31, No. 7, 2003, pp. 1915-1922. doi:10.1097/01.CCM.0000074725.62991.42
[9]	G. C. Kramer, “Hypertonic Resuscitation: Physiologic Mechanisms and Recommendations for Trauma Care,” Journal of Trauma, Vol. 54, No. 5, 2003, pp. S89-S99.
[10]	L. M. Liu, J. A. Ward and M. A. Dubick, “Effects of Crystalloid and Colloid Resuscitation on Hemorrhage-Induced Vascular Hyporesponsiveness to Norepinephrine in the Rat,” Journal of Trauma, Vol. 54, No. 5, 2003, pp. S159-S168.
[11]	K. Suzuki, T. Ajito and S. Iwabuchi. “Effect of Infusion of Hypertonic Saline Solution on Conscious Heifer with Hypoxemia Caused by Endotoxin Infusion,” American Journal of Veterinary Research, Vol. 59, No. 4, 1997, pp. 452-457.
[12]	C. H. Chen, T. J. Toung, A. Sapirstein and A. Bhardwaj, “Effect of Duration of Osmotherapy on Blood-Brain Barrier Disruption and Regional Cerebral Edema after Experimental Stroke,” Journal of Cerebral Blood Flow & Metabolism, Vol. 26, 2006, pp. 951-958. doi:10.1038/sj.jcbfm.9600248
[13]	J. A. Doyle, D. P. Davis and D. B. Hoyt, “The Use of Hypertonic Saline in the Treatment of Traumatic Brain Injury,” Journal of Trauma, Vol. 50, No. 2, 2001, pp. 367-383. doi:10.1097/00005373-200102000-00030
[14]	K. Nagasawa, H. Chiba, H. Fujita, T. Kojima, T. Saito, T. Endo and N. Sawada, “Possible Involvement of Gap Junctions in the Barrier Functions of Tight Junctions of Brain and Lung Endothelial Cells,” Journal of Cellular Physiology, Vol. 208, No. 1, 2006, pp. 123-132. doi:10.1002/jcp.20647
[15]	R. Vialet, J. Albanese, L. Thomachot, F. Antonini, A. Bourgouin, B. Alliez and C. Martin, “Isovolume Hypertonic Solutes (Sodium Chloride or Mannitol) in the Treatment of Refractory Posttraumatic Intracranial Hypertension: 2 mL/kg 7.5% Saline is More Effective Than 2 mL/kg 20% Mannitol,” Critical Care Medicine, Vol. 31, No. 6, 2003, pp. 1683-1687. doi:10.1097/01.CCM.0000063268.91710.DF
[16]	A. Bacher, J. Wei, M. R. Grafe, M. J. Quast and M. H. Zornow, “Serial Determinations of Cerebral Water Content by Magnetic Resonance Imaging after an Infusion of Hypertonic Saline,” Critical Care Medicine, Vol. 26, No. 1, 1998, pp. 108-114. doi:10.1097/00003246-199801000-00024
[17]	J. I. Suarez, A. I. Qureshi, A. Bhardwaj, M. A. Williams, M. S. Schnitzer, M. Mirski, D. F. Hanley and J. A. Ulatowski, “Treatment of Refractory Intracranial Hypertension with 23.4% Saline,” Critical Care Medicine, Vol. 26, No. 6, 1998, pp. 1118-1122. doi:10.1097/00003246-199806000-00038
[18]	N. Ito, K. Suzuki, H. Koie, S. Tsumagari, K. Kanayama, M. Miyahara and R. Asano, “The Effect of 7.2% Hypertonic Saline Solution on the Duration of Sodium Gradient between the Cerebrospinal Fluid and the Venous Circulation in the Dog,” Journal of Veterinary Medical Science, Vol. 68, No. 2, 2006, pp. 183-185. doi:10.1292/jvms.68.183
[19]	A. Somell, A. Sollevi, A. Suneson, L. Riddez and H. Hjelmqvist, “Beneficial Effects of Hypertonic Saline/Dextran on Early Survival in Porcine Endotoxin Shock,” Acta Anaesthesiologica Scandinavica, Vol. 49, No. 8, 2005, pp. 1124-1134. doi:10.1111/j.1399-6576.2005.00807.x
[20]	J. Kristensen and J. Modig, “Ringer’s Acetate and Dextran-70 with or without Hypertonic Saline in Endotoxin-Induced Shock in Pig,” Critical Care Medicine, Vol. 18, No. 11, 1990, pp. 1261-1268. doi:10.1097/00003246-199011000-00016
[21]	J. M. Pascual, J. C. Watson, A. E. Runyon, C. E. Wade and G. C. Kramer, “Resuscitation of Intraoperative Hypovolemia: A Comparison of Normal Saline and Hyperosmotic/Hyperoncotic Solutions in Swine,” Critical Care Medicine, Vol. 20, No. 2, 1992, pp. 200-210. doi:10.1097/00003246-199202000-00009
[22]	C. Battison, P. J. Andrews, C. Graham and T. Petty, “Randomized, Controlled Trial on the Effect of a 20% Mannitol Solution and a 7.5% Saline/6% Dextran Solution on Increased Intracranial Pressure after Brain Injury,” Critical Care Medicine, Vol. 33, No. 1, 2005, pp. 196-202. doi:10.1097/01.CCM.0000150269.65485.A6
[23]	National Research Concil, “Guide for the Care and Use of Laboratory Animals,” National Academy Press, Washington DC, 1996, pp. 1-70.
[24]	K. Suzuki, H. Koie, T. Matsumoto and R. Asano, “The Effect of Hypertonic Saline Solution on Vasodilatation of the Superior Sagittal Sinus Using Magnetic Resonance Imaging,” Research in Veterinary Science, Vol. 84, No. 3, 2008, pp. 465-470. doi:10.1016/j.rvsc.2007.05.016
[25]	J. E. Greenleaf, V. A. Convertino and G. R. Mangeseth. “Plasma Volume during Stress in Man: Osmolality and Red cell Volume,” Journal of Applied Physiology, Vol. 47, No. 5, 1979, pp. 1031-1038.
[26]	R. Hartl, T. F. Bardt, K. L. Kiening, A. S. Sarrafzadeh, G. H. Schneider and A. W. Unterberg, “Mannitol Decreases ICP But Does Not Improve Brain-Tissue PO2 in Severely Head-Injured Patients with Intracranial Hypertension,” Acta Neurochirurgica Supplementum, Vol. 70, 1997, pp. 40-42.
[27]	Brain Trauma Foundation, “Guidelines for the Management of Severe Traumatic Brain Injury. II. Hyperosmolar Therapy,” Journal of Neurotrauma, Vol. 24, No. 1, 2007, pp. S14-S20.
[28]	A. Sheikh, T. Matsuoka and D. Wisner, “Cerebral Effects of Resuscitation with Hypertonic Resuscitation of Shock and Brain Injury: Short- and Long-Term Effects,” Journal of Trauma, Vol. 24, No. 4, 1996, pp. 1226-1232.
[29]	A. I. Qureshi, J. I. Suarez, A. Bhardwaj, M. Mirski, M. S. Schnitzer, D. F. Hanley and J. A. Ulatowski, “Use of Hypertonic (3%) Saline/Acetate Infusion in the Treatment of Cerebral Edema: Effect on Intracranial Pressure and Lateral Displacement of the Brain,” Critical Care Medicine, Vol. 26, No. 3, 1998, pp. 440-446. doi:10.1097/00003246-199803000-00011
[30]	A. M. Mirski, I. D. Denchev, S. M. Schnitzer and F. D. Hanley, “Comparison between Hypertonic Saline and Mannitol in the Reduction of Elevated Intracranial Pressure in a Rodent Model of Acute Cerebral Injury,” Journal of Neurosurgical Anesthesiology, Vol. 12, No. 4, 2000, pp. 334-344. doi:10.1097/00008506-200010000-00006
[31]	D. Wisner, L. Schuster and C. Quinn, “Hypertonic Saline Resuscitation of Head Injury: Effects on Cerebral Water Content,” Journal of Trauma, Vol. 30, No. 1, 1990, pp. 75-78. doi:10.1097/00005373-199001000-00011
[32]	S. Holbeck, P. Bentzer and P. O. Grande, “Effects of Hypertonic Saline, Mannitol, and Urea with Regard to Absorption and Rebound Filtration in Cat Skeletal Muscle,” Critical Care Medicine, Vol. 30, No. 1, 2002, pp. 212-217. doi:10.1097/00003246-200201000-00030
[33]	E. Rozanski and M. Rondeau, “Choosing Fluids in Traumatic Hypovolemic Shock: The Role of Crystalloids, Colloids, and Hypertonic Saline,” Journal of American Animal Hospital Association, Vol. 38, No. 6, 2002, pp. 499-501.
[34]	M. M. Krausz and M. Hirsh, “Bolus Versus Continuous Fluid Resuscitation and Splenectomy for Treatment of Uncontrolled Hemorrhagic Shock after Massive Splenic Injury,” Journal of Trauma, Vol. 55, No. 1, 2003, pp. 62- 68. doi:10.1097/01.TA.0000074110.77122.46
[35]	P. Horn, E. Munch, P. Vajkoczy, P. Herrman, M. Quintel, L. Schilling, P. Schmiedek and L. Schrer, “Hypertonic Saline Solution for Control of Elevated Intracranial Pressure in Patients with Exhausted Response to Mannitol and Barbiturates,” Neurological Research, Vol. 21, No. 8, 1999, pp. 758-764.
[36]	A. V. Deliganis, D. J. Fisher, A. M. Lam and K. R. Maravilla, “Cerebrospinal Fluid Signal Intensity Increase on FLAIR MR Images in Patients under General Anesthesia: The Role of Supplemental O2,” Radiology, Vol. 218, No. 1, 2001, pp. 152-156.
[37]	A. V. Deliganis, D. J. Fisher, A. M. Lam and K. R. Maravilla, “Cerebrospinal Fluid Signal Intensity Increase on FLAIR MR Images in Patients under General Anesthesia: The Role of Supplemental O2,” Radiology, Vol. 218, No. 1, 2001, pp. 152-156.