Hypertonic Saline Solution Reduces Microcirculatory Dysfunction and Inflammation in a Rat Model of Brain Death

Area of Science:

• Physiology
• Pharmacology
• Immunology

Background:

• Brain death (BD) causes hemodynamic instability and microcirculatory hypoperfusion, leading to organ inflammation and dysfunction.
• Investigating interventions to mitigate these effects is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of 7.5% hypertonic saline solution (HSS) in addressing mesenteric microcirculatory dysfunction and inflammation in a rat model of BD.

Main Methods:

• Male Wistar rats underwent induction of brain death (BD) via intracranial balloon catheter.
• Rats were treated with either 0.9% NaCl (NS) or 7.5% HSS at different time points post-BD.
• Mesenteric microcirculation, leukocyte-endothelial interactions, and inflammatory markers were analyzed 180 minutes after BD induction.

Main Results:

• BD induced significant hypotension and reduced the proportion of perfused small mesenteric vessels compared to sham-operated rats.
• HSS treatment restored the proportion of perfused vessels and significantly reduced leukocyte rolling and migration.
• HSS modulated the expression of anti-endothelial nitric oxide synthase (eNOS) and endothelin-1, and decreased ICAM-1 levels.

Conclusions:

• HSS improves mesenteric perfused small vessel density in a rat model of BD, potentially via modulation of eNOS and endothelin-1.
• HSS demonstrates anti-inflammatory effects by decreasing leukocyte-endothelial interactions and ICAM-1 expression.
• These findings suggest HSS as a potential therapeutic agent for managing microcirculatory dysfunction and inflammation associated with brain death.