Hasan BATMAZ, Ayşe TOPAL, Sezgin ŞENTÜRK, Zeki YILMAZ, O. Sacit GÖRGÜL

Effects of hypertonic sodium chloride, hypertonic sodium chloride + sodium bicarbonate and hypertonic sodium chloride + ringer's lactade solution in the treatment of dogs with experimentally induced endotoxaemia

Bu çalışmada endotoksemili köpeklerin tedavilerinde isotonik sodyum klorür (% 0,9 ISS), hipertonik sodyum klorür (% 7,2 HSS), HSS + laktatlı ringer solüsyonu (LRS) ve HSS + sodyum bikarbonat solüsyon (% 1,3 SBS)'larının etkilerinin karşılaştırılması amaçlandı. E. coli endotoksini'nin (0111 :B4) 1 mg/kg/iv dozunda yavaş enjeksiyonu ile endotoksemi oluşturuldu. Tedavi aşamasında herbiri altı köpek içeren dört grup oluşturuldu ve herbirine farklı bir tedavi planı uygulandı. ISS, HSS, HSS + LRS ve HSS + SBS. Endotoksemi öncesi ve sonrasında klinik, hematolojik ve biyokimyasal muayeneler gerçekleştirildi. Endotoksemi anında tüm köpeklerde hipotansiyon (MAP < 60 mm Hg), lökopeni ve trombositopeni saptandı. MAP ve plazma volümü ISS grubu haricinde diğer gruplarda arttı. HCO"3 değeri HSS + SBS grubunda artmasına rağmen, diğer gruplarda azaldı. Bu nedenlerle, endotoksemili köpeklerin tedavilerinde en etkin sıvı tedavi modelinin HSS + SBS kombinasyonu olduğuna karar verildi.

Deneysel olarak endotoksemi oluşturulan köpeklerin tedavisinde hipertonik sodyum klorür, hepirtonik sodyum klorür + sodyum bikarbonat, hipertonik sodyum klorür + laktatlı ringer solusyonlarının etkileri

The aim of this study was to compare the effects of isotonic sodium chloride (ISS-0.9%), hypertonic sodium chloride (HSS-7.2%), HSS + lactate ringer solution (LRS) and HSS + sodium bicarbonate solution (SBS-1.3%) in the treatment of dogs with endotoxaemia. Endotoxaemia was induced by slow injection of a 1 mg/kg/i.v. dose of E. coli endotoxin (0111 :B4). At the treatment stage, four groups, each composed of six dogs, were formed and a different treatment plan was carried out in each group: ISS, HSS, HSS + LRS and HSS + SBS. Clinical, haematological and biochemical examinations were performed before and after endotoxaemia. Hypotension (MAP < 60 mm Hg), leukopaenia and trombocytopaenia were observed during endotoxaemia in all dogs. MAP and plasma volume were increased in all groups except the ISS group. HCO"3 values were increased in the HSS + SBS group and decreased in the other groups. Therefore, it was concluded that the HSS + SBS combination was the most effective model of fluid therapy in the treatment of dogs with endotoxaemia.

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Parillo, J.E.: Pathogenic mechanism of septic shock, Med., 1993; 328: 147M 477.
Weeren, F.R., Muir III, W.W.: Clinical aspects of septic shock and comprehensive approaches to treatment in dogs and cats, J. Am. Vet. Med. Assoc, 1992; 200 (12): 1859-1870.
Goodwin, J.K., Schaer, M.: Septic shock, Vet. Clin. N. Am. Small Anim. Prac, 1989; 19 (6): 1239-1258.
Frangogiannis, N.G., Mendoza, L.H., Smith, C.H., Michael, L.H., Entman, M.L.: Induction on the synthesis of the C- X-C chemokine interferon gamma inducible protein-10 in experimental canine endotoxemia. Cell Tissue Res., 2000; 302 (3): 365- 376.
Belloma, R., Kellum, J.A., Gandhi, J.R., Pinsky, M.R., Ondulik, B.: The effects of intensive plasma water exchange by filtration on hemodynamics and soluble mediators in canine endotoxaemia. Am. J. Respir. Crit. Care. Med., 2000; 16 (5): 1429-1436.
Pinsky, M.R., Rico, P.: Cardiac contractility is not depressed in early canine endotoxic shock. Am. J. Respir. Crit. Care. Med., 2000; 161 (4): 1087-1093.
Hayes, J.K., Luo, X., Wong, K.C., Mccames, S., Tseng, C.K.: Effects of dobutamine, norepinephrine and epinephrine or intramucosal pH and hemodynamics of dogs during endotoxic ' shock. Acta Anaesthesiol. Sen., 1998, 36 (3): 113-126.
Cohen, R.I., Huberfeld, S., Genovese, J., Steinberg, "H.N., Scarf, S.M.: A comparison between the acute effects of nitric oxide synthase inhibition and fluid resuscitation on myocardial function and metabolism, in endotoxemioshock. J. Crit. Care., 1996; 11(1): 27-36.
Barragry, T.B.: Veterinary Drug Therapy, Lea & Febiger, Philadelphia, 1994; 185-189.
Haskins, S.C.: Management of septic shock, J. Am. Vet. Med. Assoc, 1992:200(12): 1915-1924.
Kirby, R.: Shock: Aggressive resuscitation procedures, W.S.A.V.A. XVII World Cong., 1992, Rome, 609-610.
Garvey, M.S.: Fluid and electrolyte balance in critical patients. Vet. Clin. N. Am. Small. Anim. Prac, 1989; 19 (6): 1021-1057.
Zhong, J., Rubin, J.L., Parker, J.L., Edams, H.R.: Cardiodynamic response to Escherichia coll endotoxaemia: effects of fluid resuscitation. Shock, 1994; 2 (3): 203- 209.
Hardie, E.M.: Life-threatening bacterial infection, Comp. Cont. Edu., 1995; 17(6): 763-777.
Strombeck, D.R., Guilford. W.G.: Small Animal Gastroentorology, 2n(i edition, Wolfe Publishing Ltd., California, 1991; 328-330.
W olfsheimer, K.J.: Fluid therapy in the critically ill patient. Vet. Clin. N. Am. Small Anim. Prac, 1989; 19 (2): 361-379.
Batmaz, H: Effects of isotonic, hypertonic and hypertonic + isotonic sodium chloride solutions in dogs with endotoxemia. U. Ü. Vet. Fak. Derg., 1996; (1-2-3) 15: 113-127.
Schertel, E.R., Allen, D.A., Muir, W.W., Hansen, B.D.: Evaluation of a hypertonic sodium chloride/dextran solution for treatment of traumatic shock in dogs, J. Am. Vet. Med. Assoc, 1996; 208 (3): 366-370.
Ajito, T., Suziki, K., Iwabuchi, S.: Effects of intravenous infusion of a 7.2°/o hypertonic saline solution on serum electrolytes- and osmotic pressure in healthy beagles J. Vet. Med. Sci., 1999; 61 (6): 637-641.
Haskins, S.C.: Shock, Handbook of Veterinary Procedures Emergency Treatment, W.B. SaundersComp., Philadelphia, 1990; 33-52.
Ing, R.D., Nazeeri, M.N., Zeldes, S., Dulchavasky, S.A., Diebel, L.N., Scholten, D.: Hypertonic saline/dextran improves septic myocardial performance. Am Surg., 1994; 60 (7): 505-508.
Kellum, J.A., Rico, P., Garuba, A.K., Pinsky, M.R.: Accuracy of mucosal pH and mucosal arterial carbon dioxide tension for detecting mesenteric hypoperfusion in acute canine endotoxaemia. Crit. Care Med., 2000; 28 (2); 462-466.
Kellum, J.A., Bellomo, R., Kramer, D.J., Pinsky, M.R.: Etiology of metabolic acidosis during saline resuscitation in endotoxemia. Shock, 1998; 9 (5); 364-368.
Tsuchiya, R., Kyatoni, K., Scott, M.A, Nishizon, K., Ashida, Y., Mochizuki, T., Kitao, S., Yamada, T., Kobayashi K.: Role of platelet activating factor in development of thrombocytopenia and neutropenia in dogs with endotoxemia. Am. J. Vet. Res., 1999; 60 (2); 216-221.
Fantoni, D. T., Auner Junior, J.O., Futema, F., Cortopassi, S.R., Migliati, E.R., Faustino, M., De Oliveria, CM. : Intravenous administration of hypertonic sodium chloride solution with dextran or isotonic sodium chloride solution for treatment of septic shock secondary to pyometra in dogs. J. Am. Vet. Med. Assoc, 1999; 215(99): 128-1287.
Yılmaz, Z.: The effects of dobutamine, methylprednisolone, flunixin meglumine and enalapril in the treatment of dogs with experimentally induced septic shock, U. Ü. Vet. Fak. Derg., 2000; 19(1-2): 1-7.
Brown, M.R., Rogers, K.S.: Neutropenia in dogs and cats. A retrospective study of 261 cases. J. Am. Anim. Hosh. Assoc, 2001:37(2): 131-139.
Bush B.M.: Interpretation of Laboratory Results for Small Animal Clinicians, Blackwell Scientific Publications, London, 1991; 31- 330.
Luypeart, P., Vincent, J.L, Domb, M., Linden, P.V., Blecic, S., Azimi, G., Bernard, A.: Fluid resusitation with hypertonic saline in endotoxic shock. Circ. Shock, 1986; 20: 311-320.
Green, E.M., Adams, H.R.: New perspectives in circulatory shock: Pathophysiologic mediators of the mammalian response to endotoxaemia and sepsis, J. Am. Vet. Med. Assoc, 1992; 200 (12): 1834-1841
Arnold, P., Suter, P.F., Hagen, A.: New aspects of therapy in hypovolemic and septic shock in small animals, Kleintierpraxis, 1995:40:321-329.
Sing, S., Annig, P.B., Winlove, C.P., Evans, T.W.: Regional transcapillary albumin exchange in rodent endotoxaemia: effects of fluid resuscitation and inhibition of nitric oxide synthase. Clin. Sci. (Colch), 2001; 100 (1): 81-89.
Dupe, R., Bywater, R.J., Goddard, M.: A hypertonic infusion in the treatment of experimental shock in calves and clinical shock in dogs and cats, Vet. Rec, 1993; 133: 585-590.
Duval, D.: Use of hypertonic saline solutions in hypovolemic shock. Comp. Cont. Edu., 1995; 17(10): 1228-1231.
Funk, W., Baldinger, V.: Microcirculatory perfusion during volume therapy: a comparative study using crystalloid or colloid in awake animals. Anesthesiology, 1995; 82 (4): 975-982.
Constable, P.D., Schmall, L.M., Muir 111, W.W.: Respiratory, renal, hematologic and serum biochemical effects of hypertonic saline solution in endotoxemic calves, Shock, 1991; 52 (7): 990-998.