Comparison of Equivolume, Equiosmolar Solutions of Mannitol and Hypertonic Saline with or without Furosemide on Brain Water Content in Normal Rats

Wang, Liang Chao; Papangelou, Alexander; Lin, Chih-Lung; Mirski, Marek A.; Gottschalk, Allan; Toung, Thomas J. K.

doi:10.1097/aln.0b013e31828156ff

Cited by 24 publications

(18 citation statements)

References 31 publications

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“…The other reason was the potential of furosemide for reducing brain water content. The authors are aware that for this purpose, the usefulness of furosemide has been proven only in combination with either mannitol or hypertonic saline [ 14 – 16 ], but unfortunately none of the two solutions was promptly available. Despite the fact that IBP stopped rising after the second injection of furosemide, it is difficult to distinguish whether this was dependent on furosemide or rather the phenomenon was self-limiting.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic cerebral arterial gas embolism from flushing of the arterial line in two calves

et al. 2018

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BackgroundMeasurement of invasive blood pressure as reflection of blood flow and tissue perfusion is often carried out in animals during general anesthesia. Intravascular cannulation offers the potential for gas to directly enter the circulation and lead to arterial gas embolism. Cerebral arterial gas embolism may cause a spectrum of adverse effects ranging from very mild symptoms to severe neurological injury and death. Although several experimental models of arterial gas embolism have been published, there are no known published reports of accidental iatrogenic cerebral arterial gas embolism from flushing of an arterial line in animals.Case presentationA 7-day-old Red Holstein–Friesian calf (No. 1) and a 28-day-old Holstein–Friesian calf (No. 2) underwent hot iron disbudding and sham disbudding, respectively, under sedation and cornual nerve anesthesia. Invasive arterial blood pressure was measured throughout the procedure and at regular intervals during the day. Before disbudding, a sudden and severe increase of blood pressure was observed following flushing of the arterial line. Excitation, hyperextension of the limbs and rapid severe horizontal nystagmus appeared shortly thereafter. Over the following minutes, symptoms ameliorated and blood pressure normalized in both cases. Prompt diagnosis was missed in calf 1; supportive fluid therapy was provided. Severe deterioration of neurologic status occurred in the following 24 h and culminated with stupor. The calf was euthanized for ethical reasons and the histological examination revealed extensive cerebral injury. Treatment of calf 2 consisted of supportive fluid and oxygen therapy; furosemide (1 mg/kg IV) was injected twice. Calf 2 appeared clinically normal after 2 h and showed no neurologic sequelae on a 3-month-follow up period.ConclusionsThere are no known reports of cerebral arterial gas embolism following flushing of the auricular arterial line in calves. The injection of a small amount of air at high pressure in a peripheral artery may lead to a significant cerebral insult. The clinical presentation is non-specific and can favour misdiagnosis and delay of therapy.

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Section: Discussionmentioning

confidence: 99%

Iatrogenic cerebral arterial gas embolism from flushing of the arterial line in two calves

et al. 2018

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“…The diuretic effect is an important component of the MTL effect on the brain [ 5 , 6 , 28 ]. The diuretic response to MTL, which onsets almost immediately, is strongest during the first 10 minutes after MTL infusion [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of hypertonic saline and mannitol on cortical cerebral microcirculation in a rabbit craniotomy model

et al. 2015

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BackgroundHyperosmolar 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.MethodsRabbits (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.ResultsNo 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.ConclusionsOur findings suggest that an equivolemic, equiosmolar HTS solution better preserves perfusion of cortical brain microcirculation compared to MTL in a rabbit craniotomy model.

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“…We have used this method of collecting rat urine in our earlier studies (Toung, Nyquist, & Mirski, 2008;Wang, Panpangelou, Lin, & Mirski, 2013). This technique was successfully applied to all animals tested.…”

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confidence: 99%

Laryngeal mask airway for urine collection in anesthetized rats

Papangelou

Kulikowicz

Toung

2017

Animal Physiology Nutrition

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Comparison of Equivolume, Equiosmolar Solutions of Mannitol and Hypertonic Saline with or without Furosemide on Brain Water Content in Normal Rats

Abstract: When compared to equivolume, equiosmolar administration of HS, mannitol reduced brain water content to a greater extent over the entire course of the 5-h experiment. When furosemide was added to HS, the brain-dehydrating effect could not be distinguished from that of mannitol.

Cited by 24 publications

References 31 publications

Iatrogenic cerebral arterial gas embolism from flushing of the arterial line in two calves

Iatrogenic cerebral arterial gas embolism from flushing of the arterial line in two calves

Effects of hypertonic saline and mannitol on cortical cerebral microcirculation in a rabbit craniotomy model

Laryngeal mask airway for urine collection in anesthetized rats

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