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Effects of hypertonic (3%) saline in rats with circulatory shock and cerebral ischemia after heatstroke
Authors:Jinn-Rung?Kuo  Chia-Li?Lin  Chung-Ching?Chio  Jhi-Joung?Wang  Email author" target="_blank">Mao-Tsun?LinEmail author
Institution:(1) Section of Neurosurgery, Department of Surgery, Chi-Mei Medical Center, Yung-Kang City, Tainan, Taiwan;(2) Department of Medical Research, Chi-Mei Medical Center, Yung-Kang City, Tainan, Taiwan
Abstract:Objective To evaluate the effects of hypertonic (3%) saline in heatstroke rats with circulatory shock, intracranial hypertension, and cerebral ischemia.Design and setting Urethane-anesthetized rats were exposed to a high ambient temperature of 42°C until mean arterial pressure and local cerebral blood flow (CBF) in the corpus striatum began to decrease from their peak levels, which was arbitrarily defined as the onset of heatstroke. Control rats were exposed to 24°C.Measurements and results Extracellular concentrations of glutamate and lactate/pyruvate ratio (cellular ischemia markers), and glycerol (a cellular injury marker) in the corpus striatum of rat brain were assessed by intracerebral microdialysis methods. Striatal PO2, temperature, and local CBF were measured with a combined OxyLite PO2, thermocouple, and OxyFlo LDF, respectively. The values of mean arterial pressure, cerebral perfusion pressure, and striatal CBF and PO2 in rats treated with 0.9% NaCl solution after the onset of heatstroke were all significantly lower than those in normothermic controls. In contrast, the values of intracranial pressure, brain temperature, and extracellular concentrations of glutamate, glycerol, and lactate/pyruvate in the corpus striatum were greater. Intravenous infusion of hypertonic (3%) saline solution either "0" time before the start of heat exposure or right after the onset of heatstroke significantly attenuated the heatstroke-induced arterial hypotension, intracranial hypertension, decreased cerebral perfusion, and cerebral ischemia and damage and resulted in prolongation of survival time.Conclusions Our results strongly suggest that the experimental heatstroke syndromes can be effectively prevented and treated by hypertonic saline.An editorial regarding this article can be found in the same issue ()
Keywords:Heatstroke  Shock  Cerebral ischemia  Neuronal damage  Hypertonic saline intracranial hypertension
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