Investigation of the infusion solutions of different qualitative composition influence on the dynamics of neuron specific enolase activity in patients with acute ischemic stroke
DOI:
https://doi.org/10.14739/2310-1210.2018.6.146545Keywords:
ischemia, stroke, solution, NSE, GEK 130, HAES-LX-5 %, 0.9 % NaCl, mannitolAbstract
At the moment, the question remains insufficiently studied what kind of infusion fluids or their combination should be preferred in patients with acute ischemic stroke (AIS) to provide intensive care.
Purpose. To investigate the dynamics of neuron-specific enolase (NSE) against the background of the iso-osmolar 0.9 % NaCl solution, colloid iso-osmolar fluid HES 130, colloid hyperosmolar fluid HAES-LX-5 % and hyperosmolar fluid mannitol application in AIS.
Materials and methods. The study included 32 patients with AIS. As the studied solutions were used: colloid hyperosmolar HAES-LX-5 % (Gekoton), colloid iso-osmolar hydroxyethyl crystal 6 % 130/04 (HES 130), hyperosmolar mannitol 15 %, and iso-osmolar 0.9 % NaCl. The control group consisted of patients receiving only 0.9 % NaCl, the comparison groups – the patients receiving 0.9 % NaCl + HES 130 or 0.9 % NaCl + HAES-LX-5 %, or 0.9 % NaCl + mannitol. NSE activity was used as a marker of cerebral ischemia at the corresponding time (the 1st, 4th and 7th days).
Results. An increase in NSE (P < 0.05) was observed in the 0.9 % NaCl group at the 7th day of stroke. A similar dynamics of NSE elevation was in the group with mannitol (P < 0.05), as well as in the control group. A 17.3 % decrease in the NSE activity was noted in the application of HES 130 at the end of observation relative to the 1st day. The NSE activity decreased by 34.6 % (P < 0.05) on the 7th day in comparison with the 1st day in the HAES-LX-5 % group and was significantly less than in the control group, groups of HES 130 and mannitol – on average 2.88 times and 30.3 %, 39.8 %, respectively.
Conclusions. The use of 0.9 % NaCl or 0.9 % NaCl + mannitol within 7 days in patients with AIS in addition to basic therapy was accompanied by an increase in NSE. Infusion of 0.9 % NaCl + HES 130 or 0.9 % NaCl + HAES-LX-5 % was accompanied by a decrease in NSE activity at the 7th day of treatment, herewith the HAES-LX-5 % group showed the best dynamics of NSE activity decreasing (P < 0.05).
References
Zozulya, I.S., Zozulya, A.I. (2014). Mozgovoy insult: nastoyaschee i perspektivy [Brain Stroke: Present and Prospects]. Emergency Medicine, 4 (12), 8-14. [in Russian].
Belenichev I.F., Cherniy V.I., Nagornaya E.A., Pavlov S.V., Bukhtiyarova N.V. (2015). Neyroprotektsiya i neyroplastichnost [Neuroprotection and Neuroplasticity]. Kyiv, LLC "Logos". [in Russian].
Eskes, G.A., Lanctôt, K.L., Herrmann, N., Lindsay, P., Bayley, M., Bouvier, L., Dawson, D., Egi, S., Gilchrist, E., Green, T., Gubitz, G., Hill, M.D., Hopper, T., Khan, A., King, A., Kirton, A., Moorhouse, P., Smith, E.E., Green, J., Foley, N., Salter, K., Swartz, R.H. (2015). Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue Following Stroke Practices Guidelines, update 2015. Int. J. Stroke, (29), 1-356.
Birnbaum, L.A., Rodriguez, J.S., Topel, C.H., Behrouz, R., Misra, V., Palacio, S., Patterson, M.G., Motz, D.S., Goros, M.W., Cornell, J.E., Caron, J.R. (2016). Older Stroke Patients with High Stroke Scores Have Delayed Door-To-Needle Times. J Stroke Cerebrovasc Dis., 25(11), 2668-2672.
Pan, J., Li, X., Peng, Y., (2016). Remote ischemic conditioning for acute ischemic stroke: dawn in the darkness. Rev. Neurosci, 27 (5), 501-510.
Tsivgoulis, G., Sharma, V.K., Mikulik, R., Krogias, C., Haršány, M., Bavarsad Shahripour, R., Athanasiadis, D., Teoh, H.L., Piperidou, C., Alexandrov, A.V. (2014). Intravenous thrombolysis for acute ischemic stroke occurring during hospitalization for transient ischemic attack. Int. J. Stroke, 9 (4), 413-418.
García-Pastor, A., Díaz-Otero, F., Funes-Molina, C., Benito-Conde, B., Grandes-Velasco, S., Sobrino-García, P., Vázquez-Alén, P., Fernández-Bullido, Y., Villanueva-Osorio, J.A., Gil-Núñez, A. (2015). Tissue Plasminogen Activator for Acute Ischemic Stroke: The calculation of the dose based on the estimated patient's weight can increase the risk of cerebral bleeding. J. Thromb. Thrombolysis, (21), 1228-1230.
Brodoehl, S., Günther, A., Witte, O.W., Klingner, C.M. (2015). How to manage thrombolysis interruptions in acute stroke? Clin. Neuropharmacol, 38 (3), 85-88.
Cherniy, V.I., Elsky, V.N., Gorodnik, G. A., (2007). Ostraya tserebralnaya nedostatochnost [Acute cerebral insufficiency]. Donetsk, LLC "Promin". [in Russian].
James D. Geyer, Camilo R. Gomez. (2009). Stroke A practical approach. Lippincott Williams & Wilkins.
Molnar, T., Pusch, G., Papp, V., Feher, G., Szapary, L., Biri, B., Nagy, L., Keki, S., Illes, Z. (2014). The L-arginine pathway in acute ischemic stroke and severe carotid stenosis: temporal profiles and association with biomarkers and outcome. J. Stroke Cerebrovasc. Dis., 23(8), 2206–2214.
Lehmann, L., Bendel, S., Uehlinger, D.E., Takala, J., Schafer, M., Reinert, M., Jakob, S.M. (2013). Randomized, double-blind trial of the effect of fluid composition on electrolyte, acid base, and fluid homeostasis in patients early after subarachnoid hemorrhage. Neurocrit. Care, 18 (1), 5-12.
Grigor’ev, E.V., Vavin, G.V., Grishanov, T.G. (2010). Neyronspetsificheskie belki – markery entsefalopatiyi pri tyazheloy sochetannoy travme [Neuronspecific proteins - markers of encephalopathy with severe combined trauma]. Medicine of emergency conditions, 2 (27), 72-76. [in Russian].
Semenenko, A.I. (2013). Dynamika aktyvnosti neiron-spetsyfichnoi enolazy ta vmistu bilka S 100 u krovi schuriv za umov hostroho porushennia mozkovoho krovoobihu ta kursovoho vvedennia 0,9 % rozchynu NaCl [Dynamics of activity of neuron-specific enolase and the content of S100 protein in blood of rats in conditions of acute cerebrovascular accident and course administration of 0.9% NaCl]. Pharmacology and drug toxicology, 6 (36), 9-13. [in Ukrainian].
Piskunov, A.K. (2010). Biomarkery neyrovospaleniya [Biomarkers of neuroinflation]. Neurochemistry, 27(1), 63-73. [in Russian].
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