[HTML][HTML] Influence of fluid resuscitation on renal microvascular PO2 in a normotensive rat model of endotoxemia
T Johannes, EG Mik, B Nohé, NJH Raat, KE Unertl… - Critical Care, 2006 - Springer
T Johannes, EG Mik, B Nohé, NJH Raat, KE Unertl, C Ince
Critical Care, 2006•SpringerIntroduction Septic renal failure is often seen in the intensive care unit but its pathogenesis is
only partly understood. This study, performed in a normotensive rat model of endotoxemia,
tests the hypotheses that endotoxemia impairs renal microvascular PO 2 (μPO 2) and
oxygen consumption (VO 2, ren), that endotoxemia is associated with a diminished kidney
function, that fluid resuscitation can restore μPO 2, VO 2, ren and kidney function, and that
colloids are more effective than crystalloids. Methods Male Wistar rats received a one-hour …
only partly understood. This study, performed in a normotensive rat model of endotoxemia,
tests the hypotheses that endotoxemia impairs renal microvascular PO 2 (μPO 2) and
oxygen consumption (VO 2, ren), that endotoxemia is associated with a diminished kidney
function, that fluid resuscitation can restore μPO 2, VO 2, ren and kidney function, and that
colloids are more effective than crystalloids. Methods Male Wistar rats received a one-hour …
Introduction
Septic renal failure is often seen in the intensive care unit but its pathogenesis is only partly understood. This study, performed in a normotensive rat model of endotoxemia, tests the hypotheses that endotoxemia impairs renal microvascular PO2 (μPO2) and oxygen consumption (VO2,ren), that endotoxemia is associated with a diminished kidney function, that fluid resuscitation can restore μPO2, VO2,ren and kidney function, and that colloids are more effective than crystalloids.
Methods
Male Wistar rats received a one-hour intravenous infusion of lipopolysaccharide, followed by resuscitation with HES130/0.4 (Voluven®), HES200/0.5 (HES-STERIL® ® 6%) or Ringer's lactate. The renal μPO2 in the cortex and medulla and the renal venous PO2 were measured by a recently published phosphorescence lifetime technique.
Results
Endotoxemia induced a reduction in renal blood flow and anuria, while the renal μPO2 and VO2,ren remained relatively unchanged. Resuscitation restored renal blood flow, renal oxygen delivery and kidney function to baseline values, and was associated with oxygen redistribution showing different patterns for the different compounds used. HES200/0.5 and Ringer's lactate increased the VO2,ren, in contrast to HES130/0.4.
Conclusion
The loss of kidney function during endotoxemia could not be explained by an oxygen deficiency. Renal oxygen redistribution could for the first time be demonstrated during fluid resuscitation. HES130/0.4 had no influence on the VO2,ren and restored renal function with the least increase in the amount of renal work.
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