EFFECT OF HYPERTONIC NACL-STARCH-SOLUTION ON EDEMA OF DIFFERENT PATHOGENESIS

Small volumes of hypertonic NaCl-solutions have been proven to restore haemodynamics in hypovolemic shock patients. Topic of this study was to investigate whether bolus application of 7.5% NaCl-6.5% starch solu tion (HSS) apart from its relevance in shock might be an effective the rapy in oedema. Considering differential therapeutic aspects, the volu me effects of 7.2 mi HSS were tested in three types of oedema: hydrost atic oedema induced by venous congestion (n=6), oedema caused by brady kinin injection (n=6), and proteinase-induced oedema (n=6). The arteri al, venous pressure and weight changes indicating volume shifts betwee n intra- and extravascular space were continuously monitored in 36 iso lated perfused rabbit hindlimbs. Oedema formation was induced correspo nding to a weight gain of 18-20 g. Subsequently 7.2 ml HSS were inject ed into the extracorporeal circulation system containing 200 ml cell f ree, isoosmotic perfusate. Six experiments of each oedema group withou t HSS-application served as controls. 75-100% of oedema formation coul d be remobilised via bolus application of HSS within 5 min in all type s of oedema. A persisting weight reduction was detectable in the hydro static and bradykinin oedema, whereas in the elastase oedema the initi al weight loss was followed by a regain of weight up to 180% of initia l oedema formation at 120 min after HSS-application. The results show that, due to the osmotic gradient induced by bolus application of HSS, the hydrostatic and bradykinin oedema can be permanently remobilised, whereas the therapeutic effect during proteinase oedema is only short -lasting due to an irreversible damage of barrier function.