Zaporožskij Medicinskij Žurnal (Dec 2018)
Investigation of the infusion solutions of different qualitative composition influence on the dynamics of neuron specific enolase activity in patients with acute ischemic stroke
Abstract
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).
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