A comparative study on the efficacy of 10% hypertonic saline and equal volume of 20% mannitol in the treatment of experimentally induced cerebral edema in adult rats.

Abstract

BACKGROUND:

Hypertonic saline and mannitol are commonly used in the treatment of cerebral edema and elevated intracranial pressure (ICP) at present. In this connection, 10% hypertonic saline (HS) alleviates cerebral edema more effectively than the equal volume of 20% mannitol. However, the exact underlying mechanism for this remains obscure. This study aimed to explore the possible mechanism whereby 10% hypertonic saline can ameliorate cerebral edema more effectively than mannitol.

RESULTS:

Adult male Sprague-Dawley (SD) rats were subjected to permanent right-sided middle cerebral artery occlusion (MCAO) and treated with a continuous intravenous infusion of 10% HS, 20% mannitol or D-[1-3H(N)]-mannitol. Brain water content (BWC) as analyzed by wet-to-dry ratios in the ischemic hemisphere of SD rats decreased more significantly after 10% HS treatment compared with 20% mannitol. Concentration of serum Na+ and plasma crystal osmotic pressure of the 10% HS group at 2, 6, 12 and 18 h following permanent MCAO increased significantly when compared with 20% mannitol treated group. Moreover, there was negative correlation between the BWC of the ipsilateral ischemic hemisphere and concentration of serum Na+, plasma crystal osmotic pressure and difference value of concentration of serum Na+ and concentration of brain Na+ in ipsilateral ischemic hemisphere in the 10% HS group at the various time points after MCAO. A remarkable finding was the progressive accumulation of mannitol in the ischemic brain tissue.

CONCLUSIONS:

We conclude that 10% HS is more effective in alleviating cerebral edema than the equal volume of 20% mannitol. This is because 10% HS contributes to establish a higher osmotic gradient across BBB and, furthermore, the progressive accumulation of mannitol in the ischemic brain tissue counteracts its therapeutic efficacy on cerebral edema.

• Authors: Hong-Ke Zeng, Qiao-Sheng Wang, Yi-Yu Deng, Wen-Qiang Jiang, Ming Fang, Chun-Bo Chen, Xin Jiang
• Journal: BMC neuroscience (BMC Neurosci) Vol. 11 Pg. 153 (Dec 10 2010) ISSN: 1471-2202 [Electronic] England
• PMID: 21143951 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Saline Solution, Hypertonic
• Mannitol

Topics

• Animals
• Brain Edema (drug therapy, etiology)
• Disease Models, Animal
• Infarction, Middle Cerebral Artery (complications, drug therapy)
• Male
• Mannitol (metabolism, pharmacology, therapeutic use)
• Osmotic Pressure (drug effects, physiology)
• Rats
• Rats, Sprague-Dawley
• Saline Solution, Hypertonic (pharmacology, therapeutic use)