Potential risk of artificial cerebrospinal fluid solution without magnesium ion for cerebral irrigation and perfusion in neurosurgical practice.
Potential risk of artificial cerebrospinal fluid solution without magnesium ion for cerebral irrigation and perfusion in neurosurgical practice.
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DOI：
10.2176/nmc.oa2012-0295
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发表时间：
2013
影响因子：
1.9
通讯作者：
Nakao Y
中科院分区：
文献类型：
--
作者：
Mori K;Yamamoto T;Miyazaki M;Hara Y;Koike N;Nakao Y
研究了用含有不同浓度镁离子（Mg 2+）的人工脑脊液（CSF）冲洗对狗血管痉挛动脉的影响。用15只Beagle犬建立蛛网膜下腔出血模型，诱发脑血管痉挛。通过放置在小脑延髓池中的微导管进行脑池冲洗1小时，其中使用具有生理浓度Mg 2+（2.2 mEq/l）的市售人工CSF（ARTCEREB®）（ACM组，n = 5）、不含Mg 2+的ARTCEREB溶液（ACR组，n = 5）和具有较高Mg 2+浓度（5 mEq/l）的ARTCEREB溶液（ACMM组，n = 5）。测量脑脊液电解质浓度以及基底动脉和椎动脉的直径。在ACM组中，未检测到CSF Mg 2+浓度或动脉直径的变化。在ACR组中，CSF Mg 2+从基线值1.4 ± 0.03 mEq/l显著降低至0.8 ± 0.07 mEq/l，基底动脉和椎动脉直径从基线值0.74 ± 0.22 mm和0.68 ± 0.17 mm显著降低至0.61 ± 0.18 mm和0.57 ± 0.23 mm，分别在ACMM组中，CSF Mg 2+从基线值1.4 ± 0.05 mEq/l显著增加至2.4 ± 0.15 mEq/l，基底动脉和椎动脉直径从基线值0.71 ± 0.21 mm和0.69 ± 0.24 mm显著增加至0.84 ± 0.19 mm和0.90 ± 0.22 mm，分别用不含Mg 2+的人工CSF溶液冲洗可引起脑动脉血管收缩。用含适当Mg 2+浓度的人工CSF冲洗至关重要，尤其是在蛛网膜下腔出血患者中。
The effect of irrigation with artificial cerebrospinal fluid (CSF) containing various magnesium ion (Mg2+) concentrations on vasospastic arteries was investigated in the dog. Cerebral vasospasm was induced by the experimental subarachnoid hemorrhage model in 15 beagle dogs. Cisternal irrigation was performed for 1 hour via a microcatheter placed in the cisterna magna with commercially available artificial CSF (ARTCEREB®) with physiological concentration of Mg2+ (2.2 mEq/l) (ACM group, n = 5), ARTCEREB solution without Mg2+ (ACR group, n = 5), and ARTCEREB solution with higher Mg2+ concentration (5 mEq/l) (ACMM group, n = 5). CSF electrolyte concentrations and the diameters of the basilar and vertebral arteries were measured. In the ACM group, no changes were detected in either CSF Mg2+ concentration or arterial diameters. In the ACR group, the CSF Mg2+ decreased significantly to 0.8 ± 0.07 mEq/l from the baseline value of 1.4 ± 0.03 mEq/l, and both basilar and vertebral artery diameters were significantly decreased to 0.61 ± 0.18 mm and 0.57 ± 0.23 mm from their baseline values of 0.74 ± 0.22 mm and 0.68 ± 0.17 mm, respectively. In the ACMM group, the CSF Mg2+ significantly increased to 2.4 ± 0.15 mEq/l from the baseline value of 1.4 ± 0.05 mEq/l, and both basilar and vertebral artery diameters were significantly increased to 0.84 ± 0.19 mm and 0.90 ± 0.22 mm from their baseline values of 0.71 ± 0.21 mm and 0.69 ± 0.24 mm, respectively. Irrigation with artificial CSF solution without Mg2+ causes vasoconstriction of the cerebral artery. Irrigation with artificial CSF with appropriate Mg2+ concentration is essential, especially in patients with subarachnoid hemorrhage.