Effects of different sodium concentrations in fluids on brain, lung, and kidney in experimental ischemic stroke

Abstract Fluid administration is a key component in the management of acute ischemic stroke (AIS). However, the effects of different sodium concentrations in resuscitation fluids, particularly on distal organ function, remain controversial. This study compared the impact of four commonly used fluids...

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Main Authors: Camila M. Bessa, Adriana L. Vilardo, Diogo B. Peruchetti, Pedro H. L. Conceição, Celso Caruso-Neves, Vera L. Capelozzi, Denise Battaglini, Chiara Robba, Paolo Pelosi, Manu L. N. G. Malbrain, Patricia R. M. Rocco, Pedro L. Silva, Cynthia S. Samary
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-12491-9
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author Camila M. Bessa
Adriana L. Vilardo
Diogo B. Peruchetti
Pedro H. L. Conceição
Celso Caruso-Neves
Vera L. Capelozzi
Denise Battaglini
Chiara Robba
Paolo Pelosi
Manu L. N. G. Malbrain
Patricia R. M. Rocco
Pedro L. Silva
Cynthia S. Samary
author_facet Camila M. Bessa
Adriana L. Vilardo
Diogo B. Peruchetti
Pedro H. L. Conceição
Celso Caruso-Neves
Vera L. Capelozzi
Denise Battaglini
Chiara Robba
Paolo Pelosi
Manu L. N. G. Malbrain
Patricia R. M. Rocco
Pedro L. Silva
Cynthia S. Samary
author_sort Camila M. Bessa
collection DOAJ
description Abstract Fluid administration is a key component in the management of acute ischemic stroke (AIS). However, the effects of different sodium concentrations in resuscitation fluids, particularly on distal organ function, remain controversial. This study compared the impact of four commonly used fluids—0.9% isotonic saline (ISO), 0.45% hypotonic saline (HYPO), 1.5% hypertonic saline (HYPER), and 5% glucose (GLUCO)—on perilesional brain tissue, lungs, and kidneys following AIS. AIS was induced in 28 male Wistar rats. Three hours after stroke induction, animals were randomized to receive one of the four fluids. In the brain, the ISO group showed significantly higher expression of versican and hyaluronan compared to the HYPER group (p = 0.022 and p = 0.018, respectively). Conversely, the HYPER group exhibited significantly elevated levels of interleukin-1β (IL-1β), vascular cell adhesion molecule-1 (VCAM-1), and zonula occludens-1 (ZO-1) compared to the GLUCO group (p = 0.01, p = 0.02, and p = 0.006, respectively). In the lungs, the ISO group demonstrated less alveolar collapse and pulmonary edema compared to the HYPER and HYPO groups (p = 0.01 and p = 0.007, respectively). In the kidneys, both the ISO and HYPO groups showed significantly less brush-border injury than the HYPER group (p = 0.007 and p = 0.032, respectively). Furthermore, blood chloride levels declined over time in the ISO group compared to the others. In conclusion, isotonic fluid administration resulted in the least amount of injury to the brain, lungs, and kidneys in this experimental model of AIS, supporting its use as a preferred resuscitation strategy in the acute phase.
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spelling doaj-art-c177be804ca04e7cbb42489c9d7912842025-08-20T03:05:22ZengNature PortfolioScientific Reports2045-23222025-07-0115111210.1038/s41598-025-12491-9Effects of different sodium concentrations in fluids on brain, lung, and kidney in experimental ischemic strokeCamila M. Bessa0Adriana L. Vilardo1Diogo B. Peruchetti2Pedro H. L. Conceição3Celso Caruso-Neves4Vera L. Capelozzi5Denise Battaglini6Chiara Robba7Paolo Pelosi8Manu L. N. G. Malbrain9Patricia R. M. Rocco10Pedro L. Silva11Cynthia S. Samary12Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de JaneiroLaboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de JaneiroDepartment of Physiology and Biophysics, Institute of Biological Sciences, Federal University of Minas GeraisLaboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de JaneiroLaboratory of Biochemistry and Cell Signaling, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de JaneiroDepartment of Pathology, Faculty of Medicine, University of São PauloDepartment of Surgical Sciences and Integrated Diagnostics (DISC), University of GenoaDepartment of Surgical Sciences and Integrated Diagnostics (DISC), University of GenoaDepartment of Surgical Sciences and Integrated Diagnostics (DISC), University of GenoaFirst Department of Anesthesiology and Intensive Therapy, Medical University of LublinLaboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de JaneiroLaboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de JaneiroLaboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de JaneiroAbstract Fluid administration is a key component in the management of acute ischemic stroke (AIS). However, the effects of different sodium concentrations in resuscitation fluids, particularly on distal organ function, remain controversial. This study compared the impact of four commonly used fluids—0.9% isotonic saline (ISO), 0.45% hypotonic saline (HYPO), 1.5% hypertonic saline (HYPER), and 5% glucose (GLUCO)—on perilesional brain tissue, lungs, and kidneys following AIS. AIS was induced in 28 male Wistar rats. Three hours after stroke induction, animals were randomized to receive one of the four fluids. In the brain, the ISO group showed significantly higher expression of versican and hyaluronan compared to the HYPER group (p = 0.022 and p = 0.018, respectively). Conversely, the HYPER group exhibited significantly elevated levels of interleukin-1β (IL-1β), vascular cell adhesion molecule-1 (VCAM-1), and zonula occludens-1 (ZO-1) compared to the GLUCO group (p = 0.01, p = 0.02, and p = 0.006, respectively). In the lungs, the ISO group demonstrated less alveolar collapse and pulmonary edema compared to the HYPER and HYPO groups (p = 0.01 and p = 0.007, respectively). In the kidneys, both the ISO and HYPO groups showed significantly less brush-border injury than the HYPER group (p = 0.007 and p = 0.032, respectively). Furthermore, blood chloride levels declined over time in the ISO group compared to the others. In conclusion, isotonic fluid administration resulted in the least amount of injury to the brain, lungs, and kidneys in this experimental model of AIS, supporting its use as a preferred resuscitation strategy in the acute phase.https://doi.org/10.1038/s41598-025-12491-9Acute ischemic strokeInflammationBrain damageSodium concentrationFluids
spellingShingle Camila M. Bessa
Adriana L. Vilardo
Diogo B. Peruchetti
Pedro H. L. Conceição
Celso Caruso-Neves
Vera L. Capelozzi
Denise Battaglini
Chiara Robba
Paolo Pelosi
Manu L. N. G. Malbrain
Patricia R. M. Rocco
Pedro L. Silva
Cynthia S. Samary
Effects of different sodium concentrations in fluids on brain, lung, and kidney in experimental ischemic stroke
Scientific Reports
Acute ischemic stroke
Inflammation
Brain damage
Sodium concentration
Fluids
title Effects of different sodium concentrations in fluids on brain, lung, and kidney in experimental ischemic stroke
title_full Effects of different sodium concentrations in fluids on brain, lung, and kidney in experimental ischemic stroke
title_fullStr Effects of different sodium concentrations in fluids on brain, lung, and kidney in experimental ischemic stroke
title_full_unstemmed Effects of different sodium concentrations in fluids on brain, lung, and kidney in experimental ischemic stroke
title_short Effects of different sodium concentrations in fluids on brain, lung, and kidney in experimental ischemic stroke
title_sort effects of different sodium concentrations in fluids on brain lung and kidney in experimental ischemic stroke
topic Acute ischemic stroke
Inflammation
Brain damage
Sodium concentration
Fluids
url https://doi.org/10.1038/s41598-025-12491-9
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