Correction of neurological deficiency in patients with acute ischemic stroke by application of different qualitative composition of infusion solutions.

OBJECTIVE: Introduction: Infusion therapy is an important component in the treatment of patients with acute ischemic stroke (AIS). The aim: Compare the dynamics of changes neurological deficiency in the application of solutions: 0.9% NaCl, HES 130, HAES-LX-5% and mannitol 15% in patients with AIS. PATIENTS AND METHODS: Materials and methods: The study included 100 patients with AIS. As the investigated solutions were used: isosmolar 0.9% NaCl, hyperosmolar mannitol 15%, colloid-isoosmolar HES 130, colloid-hyperosmolar HAES-LX-5%. The control group received only 0.9% NaCl compared: 0.9% NaCl+HES 130, 0.9% NaCl+HAES-LX-5%, 0.9% NaCl+mannitol 15%. The evaluation of treatment efficacy (magnitude of neurological deficiency) was performed daily for 7 days using the Glasgow Coma Scale (GCS), Full Outline of UnResponsiveness (FOUR) Score, National Institutes of Health Stroke Scale (NIHSS) and BIS-index. RESULTS: Results: The conducted research showed that the application of 0.9% NaCl and mannitol did not have a significant effect on the dynamics of neurological deficits according to the GCS, FOUR and NIHSS scales for 7 days of observation (p>0.05). The use of HES 130 contributed to a statistically significant improvement in the parameters of the GCS (p<0,05), which is confirmed by significant changes in the BIS-index (p<0,05) during a seven-day infusion therapy. The most significant positive changes were observed in the group with HAES-LX-5%, which was marked by an improvement in the neurological state during 7 days treatment acoording to the GCS, FOUR and BIS index (p<0.05). CONCLUSION: Conclusions: The intergroup analysis of the neurological deficiency confirmed the worst result of treatment in the group with mannitol (p<0,05) and the best result with HAES-LX-5% (p<0,05).

Evaluation of influence of infusion therapy on the dynamics of acid alkaline balance indices in patients with acute ischemic stroke.

OBJECTIVE: Introduction: The problem of the influence of infusion solutions on the correction of acid alkaline balance disorders in acute ischemic stroke (AIS) remains unclear. The aim: Compare the dynamics of changes acid alkaline balance (AAB) in the application of isosmolar 0.9% NaCl solution and hyperosmolar solution of mannitol in patients with acute ischemic stroke. PATIENTS AND METHODS: Materials and methods: The study included 50 patients with AIS. As the investigated solutions were used: hyperosmolar mannitol 15% and isosmolar 0.9% NaCl. The control group received only 0.9% NaCl, compared with main group of 0.9% NaCl+mannitol. The research was carried out at 1, 4 and 7 day, a number of indicators were determined: рН, РаО2, РаСО2, АВ, SB, ВВ, ВЕ. RESULTS: Results: The conducted research showed that in all observation groups, on 1st day, manifestations of mixed acidosis were observed. On the 7th day of observation the group of 0.9% NaCl showed results close to the norm of the studied parameters, indicating the leveling of acidosis developed in this group on the 1st day of stroke. Somewhat worse correction of metabolic acidosis was in the group of mannitol, on the 7th day of observation the manifestations of acidosis were not significantly different from the 1st day and were respectively: pH = 7.33 (7.24; 7.36); pO2 = 36 (33; 39); AB = 23 (15; 26); BE = -3.4 (-13.5, 0.2), SB = 22.9 (18.0, 25.4). CONCLUSION: Conclusions: Analysis of changes in the parameters of AAB in the application of different circuits of infusion therapy in patients with acute ischemic stroke showed that all the observation groups had manifestations of metabolic acidosis on the first day of AIS. The ability to normalize the disturbances of acid alkaline balance did not differ significantly (p>0.05) for patients of group 0.9% NaCl solution and mannitol.