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Acute moderate hyponatraemia and its rapid correction: effects on striatal and pontine ultrastructure in an animal model of the TURP syndrome

Published online by Cambridge University Press:  23 December 2004

S. Reuss ,
K. Bürger ,
H. Claus ,
T. Reinhardt ,
U. Disque-Kaiser ,
A. L. Depta ,
M. David  and
H. W. Gervais
S. Reuss
Affiliation:
Johannes Gutenberg-University, Department of Anatomy, School of Medicine, Mainz, Germany
K. Bürger
Affiliation:
Johannes Gutenberg-University, Department of Anaesthesiology, School of Medicine, Mainz, Germany
H. Claus
Affiliation:
Johannes Gutenberg-University, Department of Anaesthesiology, School of Medicine, Mainz, Germany
T. Reinhardt
Affiliation:
Johannes Gutenberg-University, Department of Anaesthesiology, School of Medicine, Mainz, Germany
U. Disque-Kaiser
Affiliation:
Johannes Gutenberg-University, Department of Anatomy, School of Medicine, Mainz, Germany
A. L. Depta
Affiliation:
Johannes Gutenberg-University, Department of Anaesthesiology, School of Medicine, Mainz, Germany
M. David
Affiliation:
Johannes Gutenberg-University, Department of Anaesthesiology, School of Medicine, Mainz, Germany
H. W. Gervais
Affiliation:
Johannes Gutenberg-University, Department of Anaesthesiology, School of Medicine, Mainz, Germany
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Abstract

Summary

Background and objective: To investigate the effects of moderate hyponatraemia, induced by intravenous application of an electrolyte-free irrigation fluid, as a model of the human transurethral prostate resection syndrome and of its rapid correction by hypertonic saline infusion in rats.

Methods: Experimental animals received irrigation fluid (Purisole SM®) 20 mL kg−1 body weight, intravenously. In one group, hyponatraemia was subsequently rapidly corrected by infusion of hypertonic saline (NaCl 5.85%), while rats of group two were ‘sham-corrected’ by infusion of a balanced salt crystalloid solution. Plasma sodium concentrations were analysed during and at the end of the experiments. After 10 days, experimental and untreated control animals were killed humanely, fixed by perfusion and the brains were prepared for electron microscopic investigation of myelin sheets and glial cell numbers in the striatum and pons.

Results: The myelin appearance was unaltered in experimental groups compared to controls, but glial cell numbers were distinctly altered in the pons but not in the striatum. In the pons, oligodendrocytes were significantly reduced in number upon rapid correction of hyponatraemia, while astrocyte numbers were increased in rats with uncorrected hyponatraemia.

Conclusions: Our electron microscopic data demonstrate that the effects of hyponatraemia and of its rapid correction are multifarious in animals. This may also apply for human patients during transurethral prostate resection.

Keywords

ANALYSIS, blood, sodiumBRAIN DISEASES, metabolic, myelinolysis, central pontineNERVOUS SYSTEM, neurogliaRATS
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 3 , March 2004 , pp. 231 - 236
Copyright
2004 European Society of Anaesthesiology

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References

Jensen V. The TURP syndrome. Can J Anesth 1991; 38: 90–96.Google Scholar
Sunderrajan S, Bauer JH, Vopat RL, Wanner-Barjenbruch P, Hayes A. Posttransurethral prostatic resection hyponatremic syndrome: case report and review of the literature. Amer J Kidney Dis 1984; 4: 80–84.Google Scholar
Radziwill AJ, Vuadens P, Borruat FX, Bogousslavsky J. Visual disturbances and transurethral resection of the prostate: the TURP syndrome. Eur Neurol 1997; 38: 7–9.Google Scholar
Arieff AI, Ayus JC. Endometrial ablation complicated by fatal hyponatremic encephalopathy. JAMA 1993; 270: 1230–1232.Google Scholar
Rosenberg MK. Hyponatremic encephalopathy after roller-ball endometrial ablation. Anesth Analg 1995; 80: 1046–1048.Google Scholar
Cohen CD, Keuneke C, Schlemann U, et al. Hyponatraemia as a complication of colonoscopy. Lancet 2001; 357: 282–283.Google Scholar
Odeh M, Beny A, Oliven A. Severe symptomatic hyponatremia during citalopram therapy. Amer J Med Sci 2001; 321: 159–160.Google Scholar
Wang JY, Lin SH, Lin YF, Chen HY, Yu FC, Fu MT. An unforgotten cause of acute hyponatremia: Water intoxication due to oxytocin administration in a pregnant woman. Nephron 2000; 86: 342–343.Google Scholar
Anderson RJ, Chung HM, Kluge R, Schrier RW. Hyponatremia: a prospective analysis of its epidemiology and the pathogenetic role of vasopressin. Ann Int Med 1985; 102: 164–168.Google Scholar
Weissman JD, Weissman BM. Pontine myelinolysis and delayed encephalopathy following the rapid correction of acute hyponatremia. Arch Neurol 1989; 46: 926–927.Google Scholar
Clifford DB, Gado MH, Levy BK. Osmotic demyelination syndrome. Lack of pathologic and radiologic imaging correlation. Arch Neurol 1989; 46: 343–347.Google Scholar
Kleinschmidt-DeMasters BK, Norenberg MD. Rapid correction of hyponatremia causes demyelination: relation to central pontine myelinolysis. Science 1981; 211: 1068–1070.Google Scholar
Ayus JC, Krothapalli RK, Armstrong DL. Rapid correction of severe hyponatremia in the rat: histopathological changes in the brain. Amer J Physiol 1985; 248: F711–F719.Google Scholar
Paxinos G, Watson C. The Rat Brain in Stereotaxic Coordinates, 2nd edn.San Diego: Academic Press, 1986.
Reuss S. Pineal ‘synaptic’ ribbons in sympathectomized rats. Acta Anat 1989; 136: 311–314.Google Scholar
Reuss S, Mattern E, Spessert R, Riemann R, Weber A, Vollrath L. Lack of effect of oxytocin on the numbers of synaptic ribbons, cyclic guanosine monophosphate and serotonin N-acetyltransferase activity in organ-cultured pineals of three strains of rats. Cell Tissue Res 1993; 274: 337–342.Google Scholar
Hirano A. A Guide to Neuropathology.Tokyo, Japan: Igaku-Shoin, 1981.
Gocht A, Löhler J. Changes in glial cell markers in recent and old demyelinated lesions in central pontine myelinolysis. Acta Neuropathol 1990; 80: 46–58.Google Scholar
Gozal Y, Schwarzenberger J. Rapid correction of severe hyponatremia to normal values is dangerous. Anesth Analg 1995; 81: 1319–1320.Google Scholar
Sterns RH. Severe hyponatremia: the case for conservative management. Crit Care Med 1992; 20: 534–539.Google Scholar