Effects of different liquid therapies on brain water content, intracranial pressure, and expressions of aquaporin-4 and N-methyl-D-aspartate receptor-1 in cerebral tissue.

OBJECTIVE

To explore the effects of different liquid therapies on the intracranial pressure, brain water content, and expressions of aquaporin-4 and N-methyl-D-aspartate-1 in the brain tissue.

METHODS

Two intervention factors including the colloids (two levels: 4% gelofusine; 6% hydroxyethyl starch and sodium chloride injection) and the crystal/gel ratios (two levels: 0:1; 1:1) were set based on the results of the analysis of variance of factorial design. Thirty-two patient who had undergone epilepsy surgery were equally and randomly divided into four groups: group A (4% gelofusine, crystal/gel ratio 0:1); group B (6% hydroxyethyl starch and sodium chloride injection, crystal/gel ratio 0:1); group C (4% gelofusine, crystal/gel ratio 1:1); and group D (6% hydroxyethyl starch and sodium chloride injection, crystal/gel ratio 1:1). The intracranial pressure during operation was recorded. After the operation, the intracranial pressure and brain water content were measured and the expressions of aquaporin-4 and N-methyl-D-aspartate-1 in the brain tissue were determined with Western blot. Glasgow coma scores were obtained 2 hours after operation.

RESULTS

The intracranial pressure (F=55.714, P=0.000; F=142.432, P=0.000) and the brain water content (F=31.477, P=0.000; F=84.896, P=0.000) significantly increased after the application of the 6% hydroxyethyl starch and sodium chloride injection and crystal/gel ratio 1:1, and the expressions of aquaporin-4 (F=37.205, P=0.000; F=149.652, P=0.014) and N-methyl-D-aspartate-1(F=29.664, P=0.000; F=65.951, P=0.000) in the brain tissue significantly increased. There were additive effects between two of them (the intracranial pressure: F=11.056, P=0.002; the brain water content: F=8.007, P=0.008; the expression of aquaporin-4: F=9.845, P=0.004; and the expression of N-methyl-D-aspartate-1: F=5.020, P=0.033). However, the Glasgow coma score showed no significant difference after the administration (P>0.05).

CONCLUSION

The liquid therapy with 4% gelofusine and crystal/gel ratio 0:1 can result in better control on the intracranial pressure, brain water content and expressions of aquaporin-4 and N-methyl-D-aspartate-1 in the brain tissue better than the liquid therapy with 6% hydroxyethyl starch and crystal/gel ratio 1:1 during neurosurgery, although it may not improve the coma status.