Morphological and X-ray microanalytical changes in mammalian tissue after overhydration with irrigating fluids

Area of Science:

• Comparative pathology
• Toxicology
• Organ physiology

Background:

• Intravenous irrigating fluids are crucial in medical procedures.
• Assessing the potential adverse effects of irrigating solutions on vital organs is essential.
• Understanding organ-specific responses to different fluid compositions is critical for patient safety.

Purpose of the Study:

• To compare the morphological effects of five different irrigating fluids on rabbit organs.
• To evaluate the safety and potential toxicity of glycine and mannitol-based solutions.
• To identify irrigating fluids with the most favorable tissue compatibility.

Main Methods:

• Intravenous infusion of five irrigating fluids (100 ml/kg) into 30 rabbits.
• Morphological examination of heart, brain, liver, and kidneys post-infusion.
• Histopathological scoring for tissue swelling, necrosis, and inflammatory responses.
• X-ray microanalysis to assess intracellular ion content in myocardial cells.

Main Results:

• Glycine 1.5% and 1.0% (with ethanol 1%) caused significant tissue swelling, focal necrosis, and inflammation, particularly in the heart.
• Three rabbits receiving glycine 1.5% + ethanol 1% died, exhibiting bradycardia and irregular cardiac rhythm.
• Glycine solutions reduced intracellular potassium and chlorine in myocardial cells.
• Mannitol 3% + ethanol 1% demonstrated the lowest tissue swelling scores.
• Sorbitol 2% + mannitol 1% and normal saline showed intermediate tissue swelling.

Conclusions:

• Glycine-based irrigating solutions pose significant risks, including cardiotoxicity and mortality.
• Mannitol 3% + ethanol 1% appears to be the safest irrigating fluid among those tested, with minimal adverse morphological effects.
• Fluid composition critically influences organ-specific responses and overall safety during intravenous infusion.