Hypertonic saline solution for modifying tissue ischemia/reperfusion injury: Porcine aortic occlusion model

  • Bibiana Escobar Unidad de Anestesiología, Departamento de Cirugía, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
  • Oscar Alexander Guevara-Cruz Instituto de Investigaciones Clínicas, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
  • José Ricardo Navarro-Vargas Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
  • Andrés Felipe Giraldo-Fajardo Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
  • Jorge Alberto Dumar-Rodriguez Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
  • Crystian Borrero-Cortés School of Medicine, Program of Anesthesiology and Resuscitation, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
Keywords: Saline solution, Myocardial contraction, Ischemia, Stroke volumen, Perfusion, Hypertonic

Abstract

Introduction:

Decreased blood flow disrupts the endothelium, changes the nitric oxide/endothelin -1 ratio, narrows the capillaries and results in microcirculatory dysfunction. Secondary anoxia leads to mitochondrial energy imbalance, depletion of adenosine-triphosphate and disruption of the intracellular hydrogen, sodium and calcium homeostasis. If the flow is restored, the reperfusion stimulates the endothelial expression of adhesion molecules attracting polymorphic nucleotides and platelets, with sub endothelial infiltration of these cells and their entrapment in the microvasculature, as well as vasoconstriction, endothelial edema and reduced flexibility of the cellular membrane. Ischemia/reperfusion may result in inflammation and organ failure.

Objective:

To determine whether hypertonic saline solution reduces the ischemic/reperfusion injury in the liver, the kidney, and the ileum.

Materials and methods:

Experimental trial in pigs. Aortic blood flow suppression (15 min) and reperfusion (60 min). The experimental group was pretreated with 7.5% hypertonic saline and the control group received normal 0.9% saline solution. Hemodynamic, gasometric, and biochemical measurements were taken, and the serum and tissue levels of ET-1, TNF-alpha, IL-10, and IL-2 were determined.

Results:

There were no significant differences in the tissue expression of ET-1, TNF-alpha, IL-10, and IL-2 between the two groups. The hemodynamic behavior was similar in both groups. The group treated with hypertonic solution showed an increasing post-perfusion systolic rate up to the basal values, while the systolic rate in the control group dropped significantly (p = 0.015).

Conclusion:

Hypertonic solution prior to the ischemic insult improves the ventricular function after reperfusion.

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How to Cite
1.
Escobar B, Guevara-Cruz OA, Navarro-Vargas JR, Giraldo-Fajardo AF, Dumar-Rodriguez JA, Borrero-Cortés C. Hypertonic saline solution for modifying tissue ischemia/reperfusion injury: Porcine aortic occlusion model. Colomb. J. Anesthesiol. [Internet]. 2017Oct.1 [cited 2022Aug.14];45(4):280–290. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/553

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Published
2017-10-01
How to Cite
1.
Escobar B, Guevara-Cruz OA, Navarro-Vargas JR, Giraldo-Fajardo AF, Dumar-Rodriguez JA, Borrero-Cortés C. Hypertonic saline solution for modifying tissue ischemia/reperfusion injury: Porcine aortic occlusion model. Colomb. J. Anesthesiol. [Internet]. 2017Oct.1 [cited 2022Aug.14];45(4):280–290. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/553
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