Assessment of infusion therapy impact on the dynamics of endothelin-1 in patients with acute ischemic stroke

Authors

  • A. I. Semenenko National Pirogov Memorial Medical University, Vinnytsia, Ukraine,
  • N. O. Semenenko National Pirogov Memorial Medical University, Vinnytsia, Ukraine,
  • Н. I. Hrebtii Higher State Educational Establishment “Bukovinian State Medical University”, Chernivtsi, Ukraine,
  • S. L. Malуk National Pirogov Memorial Medical University, Vinnytsia, Ukraine,
  • R. Ya. Bodnar Horbachevsky Ternopil State Medical University, Ukraine,
  • O. M. Hinhuliak Higher State Educational Establishment “Bukovinian State Medical University”, Chernivtsi, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2019.1.155796

Keywords:

stroke, solutions, endothelins, HES 130, HAES-LX-5 %, 0.9 % NaCl, mannitol

Abstract

The impact of infusion solutions on endothelial damage correction in acute ischemic stroke (AIS) remains an insufficiently studied.

Purpose. To investigate the dynamics of endothelin-1 as one of the main markers of vasoconstriction and endothelial dysfunction (ED) with the use of 0.9 % NaCl, HES 130, HAES-LX-5 % and mannitol in patients with AIS.

Materials and methods. The study included 32 patients with AIS. As the investigated solutions were used: colloid hyperosmolar HAES-LX-5 % (Gecoton), colloid isoosmolar hydroxyethylstarch 6% 130/04 (HES 130), hyperosmolar mannitol 15 %, isoosmolar 0.9 % NaCl. The control group consisted of patients who received only 0.9 % NaCl, comparison group patients received 0.9% NaCl + HES 130 or 0.9 % NaCl + HAES-LX-5 %, or 0.9 % NaCl + mannitol. The level of endothelin-1 (EN-1) served as a vasoconstriction marker of ED at a fixed time (days 1, 4 and 7).

Results. Infusion therapy with only 0.9 % NaCl negatively affected the level of EN-1, since its level was 3.17 times increased on the 7th day of observation in comparison with the 4th day (P < 0.05). In the course of seven-day treatment with mannitol, a sharp increase in EN-1 serum level on average 3.73 and 3.48 times higher on day 7 (P < 0.05) compared to days 1 and 4, respectively, was observed. Infusion therapy with HES 130 and HAES-LX-5 % solutions produced a moderate depressing effect. So, the HAES-LX-5 % and HES 130 groups demonstrated a trend towards a decrease in ЕN-1 level (P > 0.05) at the end of observation in comparison with mannitol and 0.9 % NaCl groups, which showed a paradoxical increase in its level at the 7th day of infusion.

Conclusions. The dynamics of EN-1 level as the main vasoconstrictor marker of ED were negative in the group of patients with 0.9 % NaCl and mannitol: its level was 3.17 and 3.48 times increased in the 0.9 % NaCl and mannitol groups (P < 0,05), respectively, on day 7 compared to day 4 of observation. Intensive therapy with HAES-LX-5 % and HES 130 had a better depressing effect on an increase in EN-1 level than other solutions.

 

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1.
Semenenko AI, Semenenko NO, Hrebtii НI, Malуk SL, Bodnar RY, Hinhuliak OM. Assessment of infusion therapy impact on the dynamics of endothelin-1 in patients with acute ischemic stroke. Zaporozhye Medical Journal [Internet]. 2019Feb.8 [cited 2024Dec.23];(1). Available from: http://zmj.zsmu.edu.ua/article/view/155796

Issue

No. 1 (2019)

Section

Original research

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