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Effects of 6% Tetrastarch and lactated Ringer's solution on extravascular lung water and markers of acute renal injury in hemorrhaged, isoflurane-anesthetized healthy dogs

Abstract

Tetrastarch can cause acute kidney injury (AKI) in humans with sepsis, but it is less likely to result in tissue edema than lactated Ringer's solution (LRS). To compare the effects of volume replacement (VR) with LRS and 6% tetrastarch solution (TS) on extravascular lung water (EVLW) and markers of AKI in hemorrhaged dogs. Animals: Six healthy, adult English Pointer dogs (19.7-35.3 kg). In a prospective crossover study, animals underwent anesthesia without hemorrhage (Control). Two weeks later, dogs were hemorrhaged under anesthesia on two occasions (8-week washout intervals) and randomly received VR with LRS or TS at 3:1 or 1:1 of shed blood, respectively. Anesthesia was maintained until 4 h after VR for EVLW measurements derived from transpulmonary thermodilution cardiac output. Neutrophil gelatinase-associated lipocalin (NGAL) and creatinine concentrations in plasma and urine were measured until 72 h after VR. The EVLW index (mL/kg) was lower at 1 h after TS (10.0 ± 1.9) in comparison to controls (11.9 ± 3.4, P = 0.04), and at 4 h after TS (9.7 ± 1.9) in comparison to LRS (11.8 ± 2.7, P = 0.03). Arterial oxygen partial pressure-to-inspired oxygen fraction ratio did not differ among treatments from 0.5-4 h after VR. Urine NGAL/creatinine ratio did not differ among treatments and remained below the threshold for AKI (120,000 pg/mg). Although TS causes less EVLW accumulation than LRS, neither fluid produced evidence of lung edema (impaired oxygenation). Both fluids appear not to cause AKI when used for VR after hemorrhage in healthy non-septic dogs. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
DINIZ, M. S.; TEIXEIRA-NETO, F. J.; CELEITA-RODRIGUEZ, N.; GIROTTO, C. H.; FONSECA, M. W.; OLIVEIRA-GARCIA, A. C.; LOPEZ-CASTANEDA, B. Effects of 6% Tetrastarch and Lactated Ringer's Solution on Extravascular Lung Water and Markers of Acute Renal Injury in Hemorrhaged, Isoflurane-Anesthetized Healthy Dogs. JOURNAL OF VETERINARY INTERNAL MEDICINE, v. 32, n. 2, p. 712-721, MAR-APR 2018. Web of Science Citations: 3.

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