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Acute normovolaemic haemodilution with a novel hydroxyethyl starch (130/0.4) reduces focal cerebral ischaemic injury in rats

Published online by Cambridge University Press:  01 July 2008

L. Xiong ,
C. Lei ,
Q. Wang  and
W. Li
L. Xiong*
Affiliation:
Fourth Military Medical University, Xijing Hospital, Department of Anesthesiology, Xi’an, Shaanxi, China
C. Lei
Affiliation:
Fourth Military Medical University, Xijing Hospital, Department of Anesthesiology, Xi’an, Shaanxi, China
Q. Wang
Affiliation:
Fourth Military Medical University, Xijing Hospital, Department of Anesthesiology, Xi’an, Shaanxi, China
W. Li
Affiliation:
Fourth Military Medical University, Xijing Hospital, Department of Anesthesiology, Xi’an, Shaanxi, China
*
Correspondence to: Lize Xiong, Department of Anesthesiology, Xijing Hospital, Xi’an, Shaanxi Province 710032, China. E-mail: mzkxlz@126.com; Tel: +86 29 84775337; Fax: +86 29 83244986
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Summary

Background and objectives

This study investigated the neuroprotective effect of acute normovolaemic haemodilution with a novel hydroxyethyl starch (130/0.4, HES) on focal cerebral ischaemia-reperfusion injury and determined optimum degree for haemodilution in the rat.

Methods

Male Sprague-Dawley rats were randomly divided into three groups (n = 10 each): hydroxyethyl starch, saline and controls. Animals in the hydroxyethyl starch and saline groups were haemodiluted until haematocrit decreased to 30% of baseline. In another experiment male Sprague-Dawley rats were randomly assigned to four groups (n = 10 each): HES30, HES25 and HES20 and controls. Rats in the HES30, HES25 and HES20 groups were haemodiluted with hydroxyethyl starch until the haematocrit decreased to 30%, 25% and 20%, respectively. At 15 min after haemodilution, all the rats were subjected to a right middle cerebral artery occlusion for 120 min. Neurologic deficit scores and infarct volumes were assessed 24 h after reperfusion.

Results

Haemodilution with hydroxyethyl starch improved neurologic outcome (P < 0.01) and reduced infarct volume (P < 0.01) compared to saline and controls. Haemodilution with saline augmented infarct volume (P < 0.05 vs. controls). Neurologic deficit scores in HES30 and HES25 groups were significantly lower compared to controls (P < 0.05) while infarct volumes in controls and HES20 were significantly larger compared to HES30 and HES25 (P < 0.01).

Conclusions

This study demonstrates that acute normovolaemic haemodilution with a novel hydroxyethyl starch (130/0.4) reduces infarct volume and improves neurological outcome after focal cerebral ischaemia in a rat stroke model. Neuroprotection by haemodilution was highest at haematocrit dilution between 25% and 30%, while ischaemic injury was exacerbates when haematocrit was diluted to 20%.

Keywords

BRAIN ISCHAEMIARATHAEMODILUTIONHETASTARCHNEUROPROTECTION
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 7 , July 2008 , pp. 581 - 588
Copyright
Copyright © European Society of Anaesthesiology 2008

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