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Infarct Volume After Hyperacute Infusion of Hypertonic Saline in a Rat Model of Acute Embolic Stroke

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Abstract

Introduction

Hypertonic saline (HS) can treat cerebral edema arising from a number of pathologic conditions. However, physicians are reluctant to use it during the first 24 h after stroke because of experimental evidence that it increases infarct volume when administered early after reperfusion. Here, we determined the effect of HS on infarct size in an embolic clot model without planned reperfusion.

Methods

A clot was injected into the internal carotid artery of male Wistar rats to reduce perfusion in the middle cerebral artery territory to less than 40 % of baseline, as monitored by laser-Doppler flowmetry. After 25 min, rats were randomized to receive 10 mL/kg of 7.5 % HS (50:50 chloride:acetate) or normal saline (NS) followed by a 0.5 mL/h infusion of the same solution for 22 h.

Results

Infarct volume was similar between NS and HS groups (in mm3: cortex 102 ± 65 mm3 vs. 93 ± 49 mm3, p = 0.72; caudoputamenal complex 15 ± 9 mm3 vs. 21 ± 14, p = 0.22; total hemisphere 119 ± 76 mm3 vs. 114 ± 62, p = 0.88, respectively). Percent water content was unchanged in the infarcted hemisphere (NS 81.6 ± 1.5 %; HS 80.7 ± 1.3 %, p = 0.16), whereas the HS-treated contralateral hemisphere was significantly dehydrated (NS 79.4 ± 0.8 %; HS 77.5 ± 0.8 %, p < 0.01).

Conclusions

HS reduced contralateral hemispheric water content but did not affect ipsilateral brain water content when compared to NS. Infarct volume was unaffected by HS administration at all evaluated locations.

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Acknowledgments

We would like to thank Adam Schiavi for manuscript review, Claire Levine for manuscript preparation, and Patricia Lamberti for figure preparation. This work was supported by National Institutes of Health Grant NS038684 (R.C.K.).

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Meyer 8-140, Baltimore, MD, 21287-7840, USA

    Alexander Papangelou, Thomas J. K. Toung, Allan Gottschalk & Marek A. Mirski

  2. Department of Neurology, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Meyer 8-140, Baltimore, MD, 21287-7840, USA

    Alexander Papangelou & Marek A. Mirski

  3. Department of Neurosurgery, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Meyer 8-140, Baltimore, MD, 21287-7840, USA

    Marek A. Mirski

  4. Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Blalock 1404, Baltimore, MD, 21287-4961, USA

    Raymond C. Koehler

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  1. Alexander Papangelou
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Correspondence to Alexander Papangelou.

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Papangelou, A., Toung, T.J.K., Gottschalk, A. et al. Infarct Volume After Hyperacute Infusion of Hypertonic Saline in a Rat Model of Acute Embolic Stroke. Neurocrit Care 18, 106–114 (2013). https://doi.org/10.1007/s12028-012-9768-z

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