Порівняльна оцінка терапевтичної дії різних інфузійних розчинів на показники кислотно-лужної рівноваги крові щурів з гострою церебральною ішемією

Abstract

В исследованиях на крысах изучали влияние применения растворов: изоосмолярного 0,9% NaCl, коллоидно-изоосмолярного волювена и коллоидно-гиперосмолярного НАЕS-LX-5% на показатели кислотно-щелочного равновесия крови крыс при экспериментальной ишемии–реперфузии головного мозга (двусторонняя 20-минутная ишемия внутренних сонных артерий с последующей реперфузией). Установлено, что лечение крыс растворами НАЕS-LX-5% и волювеном по сравнению с 0,9% раствором NaCl приводит к уменьшению проявлений смешанного ацидоза (p < 0,05). Infusion therapy takes an important place among therapeutic measures that reduce the chance of developing cerebral ischemia in acute cerebrovascular accident. Choice of the therapy is one of the most difficult problems in the complex conservative treatment of these patients. Great interest presents the study of the influence of separate course of therapy infusion solutions of different composition on the dynamics of acid-base balance (ABB) indicators of rat venous blood. Materials and methods. Experiments were conducted on 35 white male rats. The experimental model of ischemia-reperfusion (IR) was created by blending of clips on both internal carotid arteries during propofol anesthesia (60 mg/kg) for 20 min. The animals were divided into 5 groups. Infusion solutions of 0,9 % NaCI, HAES-LX-5 % and Voluven were injected intravenously in catheterized femoral vein at 2,5 ml/kg 2 times/day (5 ml/kg per day). The first introduction was performed 30 min after IR and then daily every 12 hours for 7 days. The control group consisted of intact rats and untreated animals with IR. Blood from a vein for monitoring ABB was received by direct visual puncture. The study of ABB was carried out on the machine micro-Astup of „Medical Easy Stat USA” firm. Main indicators were studied: pH, pCO2 – partial pressure of CO2; pO2 – partial pressure of O2; AB – a true bicarbonate; SB – standard bicarbonate; BE – deficit of buffer bases. Results and discussion. The conducted study found that therapeutic use of any of the solutions was not accompanied by the restoration of the pH level in the acute phase of CVA to benchmarks. However the conducted infusion therapy contributed to reducing acidosis, although these improvements were expressed in different groups to different degrees. Comparing the effectiveness of Voluven and HAES-LX-5 % it can be noted that for the ability to restore indicators of standard and true bicarbonate to the values in intact animals both solutions are comparable, but unlike the first, HAES-LX-5 % dominated by 0,9 % NaCl in terms of deficit buffer bases. In general none of the studied drugs contribute to the full elimination of the of buffer systems deficit however against only HAES-LX-5% levels of this indicator acquire positive values. Treatment of rats with a model of cerebral ischemia with solutions HAES-LX-5 % and Voluven compared with 0,9 % NaCl solution leads to reduction of mixed acidosis manifestations (p < 0,05). Application in the postreperfusion period of 0,9 % NaCl solution unlike NAES-LX-5 % and Voluven has negative tendency to reduce the pO2 throughout the observation period which could be a basis for the formation of hypoxic brain edema. So the results of the monitoring showed that among the studied solutions the most complete de-escalation of mixed acidosis in terms of pathology managed to achieve in the course of infusion NAES-LX-5 %