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

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) 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.