Effects of resuscitation with human albumin 5%, hydroxyethyl starch 130/0.4 6%, or crystalloid on kidney damage in an ovine model of septic shock
Colloid solutions have been associated with kidney dysfunction in septic animals and humans. The present study investigated the influence of resuscitation with human albumin (HA) 5%, hydroxyethyl starch (HES) 130/0.4 6%, and balanced crystalloids on ultrastructural kidney damage, kidney function, an...
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| Veröffentlicht in: | British journal of anaesthesia : BJA 2018-09, Vol.121 (3), p.581-587 |
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| creator | Kampmeier, T.G. Arnemann, P.H. Hessler, M. Bockbreder, K. Wald, A. Morelli, A. Rehberg, S.W. Ertmer, C. |
| description | Colloid solutions have been associated with kidney dysfunction in septic animals and humans. The present study investigated the influence of resuscitation with human albumin (HA) 5%, hydroxyethyl starch (HES) 130/0.4 6%, and balanced crystalloids on ultrastructural kidney damage, kidney function, and survival in a model of ovine septic shock.
After induction of peritoneal septic shock, animals were randomised to one of the following groups: (1) HA 5%, (2) HES 130/0.4 6%, (3) balanced crystalloid, and (4) control (each n=10). Causal therapy included re-laparotomy, peritoneal lavage, and antimicrobial therapy. Sequential kidney biopsies were obtained for the assessment of the electron microscopic tubular injury (EMTI) score.
Serum creatinine and urea were highest in the control group, and there were no differences between the intervention groups. Cumulative diuresis was significantly higher in the HA group [1.0 ml kg−1 h−1 (0.6; 1.2)] compared with control [0.7 ml kg−1 h−1 (0.6; 0.9), P |
| doi_str_mv | 10.1016/j.bja.2018.04.041 |
| format | Article |
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After induction of peritoneal septic shock, animals were randomised to one of the following groups: (1) HA 5%, (2) HES 130/0.4 6%, (3) balanced crystalloid, and (4) control (each n=10). Causal therapy included re-laparotomy, peritoneal lavage, and antimicrobial therapy. Sequential kidney biopsies were obtained for the assessment of the electron microscopic tubular injury (EMTI) score.
Serum creatinine and urea were highest in the control group, and there were no differences between the intervention groups. Cumulative diuresis was significantly higher in the HA group [1.0 ml kg−1 h−1 (0.6; 1.2)] compared with control [0.7 ml kg−1 h−1 (0.6; 0.9), P<0.05]. Creatinine clearance was highest in the HA and crystalloid groups. Ultrastructural kidney damage was highest in the control group [EMTI score 7.8 (6.7; 9.0)] without differences between intervention groups. Survival was 100% in the colloid groups vs 90% (crystalloid) and 60% (control, all P<0.05).
In an ovine model of septic shock, kidney function and cumulative diuresis were preserved in the 5% albumin and crystalloid resuscitation groups, whereas HES 130/0.4 6% resulted in diminished creatinine clearance. Differences in kidney function between resuscitation fluids could not be explained by differences in ultrastructural kidney damage.
84-02.04.2011.A300.</description><identifier>ISSN: 0007-0912</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1016/j.bja.2018.04.041</identifier><identifier>PMID: 30115256</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>acute kidney injury ; fluid therapy ; HES 130–0.4 ; septic shock ; serum albumin</subject><ispartof>British journal of anaesthesia : BJA, 2018-09, Vol.121 (3), p.581-587</ispartof><rights>2018 British Journal of Anaesthesia</rights><rights>Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-3507d9a3f4edb8a4d5792dcb90bc3e7f0db0b2304d8a3808971869aad7abcbb43</citedby><cites>FETCH-LOGICAL-c396t-3507d9a3f4edb8a4d5792dcb90bc3e7f0db0b2304d8a3808971869aad7abcbb43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27911,27912</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30115256$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kampmeier, T.G.</creatorcontrib><creatorcontrib>Arnemann, P.H.</creatorcontrib><creatorcontrib>Hessler, M.</creatorcontrib><creatorcontrib>Bockbreder, K.</creatorcontrib><creatorcontrib>Wald, A.</creatorcontrib><creatorcontrib>Morelli, A.</creatorcontrib><creatorcontrib>Rehberg, S.W.</creatorcontrib><creatorcontrib>Ertmer, C.</creatorcontrib><title>Effects of resuscitation with human albumin 5%, hydroxyethyl starch 130/0.4 6%, or crystalloid on kidney damage in an ovine model of septic shock</title><title>British journal of anaesthesia : BJA</title><addtitle>Br J Anaesth</addtitle><description>Colloid solutions have been associated with kidney dysfunction in septic animals and humans. The present study investigated the influence of resuscitation with human albumin (HA) 5%, hydroxyethyl starch (HES) 130/0.4 6%, and balanced crystalloids on ultrastructural kidney damage, kidney function, and survival in a model of ovine septic shock.
After induction of peritoneal septic shock, animals were randomised to one of the following groups: (1) HA 5%, (2) HES 130/0.4 6%, (3) balanced crystalloid, and (4) control (each n=10). Causal therapy included re-laparotomy, peritoneal lavage, and antimicrobial therapy. Sequential kidney biopsies were obtained for the assessment of the electron microscopic tubular injury (EMTI) score.
Serum creatinine and urea were highest in the control group, and there were no differences between the intervention groups. Cumulative diuresis was significantly higher in the HA group [1.0 ml kg−1 h−1 (0.6; 1.2)] compared with control [0.7 ml kg−1 h−1 (0.6; 0.9), P<0.05]. Creatinine clearance was highest in the HA and crystalloid groups. Ultrastructural kidney damage was highest in the control group [EMTI score 7.8 (6.7; 9.0)] without differences between intervention groups. Survival was 100% in the colloid groups vs 90% (crystalloid) and 60% (control, all P<0.05).
In an ovine model of septic shock, kidney function and cumulative diuresis were preserved in the 5% albumin and crystalloid resuscitation groups, whereas HES 130/0.4 6% resulted in diminished creatinine clearance. Differences in kidney function between resuscitation fluids could not be explained by differences in ultrastructural kidney damage.
84-02.04.2011.A300.</description><subject>acute kidney injury</subject><subject>fluid therapy</subject><subject>HES 130–0.4</subject><subject>septic shock</subject><subject>serum albumin</subject><issn>0007-0912</issn><issn>1471-6771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1TAQhS1ERS-FB2CDvEFiQdKZ_DkRK1QVqFSJDawt_0yIb5P4YieFPAZvXF_dwrLSSLOYc77RzGHsDUKOgM3lPtd7lReAbQ5VKnzGdlgJzBoh8DnbAYDIoMPinL2McQ-AoujqF-y8BMS6qJsd-3vd92SWyH3PA8U1GreoxfmZ_3bLwId1UjNXo14nN_P63Qc-bDb4PxstwzbyuKhgBo4lXEJe8SbNfeAmbGkwjt5ZnkB3zs60casm9ZN4wiSiv3cz8clbGo-bIx0WZ3gcvLl7xc56NUZ6_dgv2I_P19-vvma3377cXH26zUzZNUtW1iBsp8q-IqtbVdladIU1ugNtShI9WA26KKGyrSpbaDuBbdMpZYXSRuuqvGDvT9xD8L9WioucXDQ0jmomv0ZZJE9bN4hdkuJJaoKPMVAvD8FNKmwSQR6TkHuZkpDHJCRUqTB53j7iVz2R_e_49_ok-HgSUDry3lGQ6fc0G7IupESk9e4J_AOsipmB</recordid><startdate>201809</startdate><enddate>201809</enddate><creator>Kampmeier, T.G.</creator><creator>Arnemann, P.H.</creator><creator>Hessler, M.</creator><creator>Bockbreder, K.</creator><creator>Wald, A.</creator><creator>Morelli, A.</creator><creator>Rehberg, S.W.</creator><creator>Ertmer, C.</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201809</creationdate><title>Effects of resuscitation with human albumin 5%, hydroxyethyl starch 130/0.4 6%, or crystalloid on kidney damage in an ovine model of septic shock</title><author>Kampmeier, T.G. ; Arnemann, P.H. ; Hessler, M. ; Bockbreder, K. ; Wald, A. ; Morelli, A. ; Rehberg, S.W. ; Ertmer, C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-3507d9a3f4edb8a4d5792dcb90bc3e7f0db0b2304d8a3808971869aad7abcbb43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>acute kidney injury</topic><topic>fluid therapy</topic><topic>HES 130–0.4</topic><topic>septic shock</topic><topic>serum albumin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kampmeier, T.G.</creatorcontrib><creatorcontrib>Arnemann, P.H.</creatorcontrib><creatorcontrib>Hessler, M.</creatorcontrib><creatorcontrib>Bockbreder, K.</creatorcontrib><creatorcontrib>Wald, A.</creatorcontrib><creatorcontrib>Morelli, A.</creatorcontrib><creatorcontrib>Rehberg, S.W.</creatorcontrib><creatorcontrib>Ertmer, C.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of anaesthesia : BJA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kampmeier, T.G.</au><au>Arnemann, P.H.</au><au>Hessler, M.</au><au>Bockbreder, K.</au><au>Wald, A.</au><au>Morelli, A.</au><au>Rehberg, S.W.</au><au>Ertmer, C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of resuscitation with human albumin 5%, hydroxyethyl starch 130/0.4 6%, or crystalloid on kidney damage in an ovine model of septic shock</atitle><jtitle>British journal of anaesthesia : BJA</jtitle><addtitle>Br J Anaesth</addtitle><date>2018-09</date><risdate>2018</risdate><volume>121</volume><issue>3</issue><spage>581</spage><epage>587</epage><pages>581-587</pages><issn>0007-0912</issn><eissn>1471-6771</eissn><abstract>Colloid solutions have been associated with kidney dysfunction in septic animals and humans. The present study investigated the influence of resuscitation with human albumin (HA) 5%, hydroxyethyl starch (HES) 130/0.4 6%, and balanced crystalloids on ultrastructural kidney damage, kidney function, and survival in a model of ovine septic shock.
After induction of peritoneal septic shock, animals were randomised to one of the following groups: (1) HA 5%, (2) HES 130/0.4 6%, (3) balanced crystalloid, and (4) control (each n=10). Causal therapy included re-laparotomy, peritoneal lavage, and antimicrobial therapy. Sequential kidney biopsies were obtained for the assessment of the electron microscopic tubular injury (EMTI) score.
Serum creatinine and urea were highest in the control group, and there were no differences between the intervention groups. Cumulative diuresis was significantly higher in the HA group [1.0 ml kg−1 h−1 (0.6; 1.2)] compared with control [0.7 ml kg−1 h−1 (0.6; 0.9), P<0.05]. Creatinine clearance was highest in the HA and crystalloid groups. Ultrastructural kidney damage was highest in the control group [EMTI score 7.8 (6.7; 9.0)] without differences between intervention groups. Survival was 100% in the colloid groups vs 90% (crystalloid) and 60% (control, all P<0.05).
In an ovine model of septic shock, kidney function and cumulative diuresis were preserved in the 5% albumin and crystalloid resuscitation groups, whereas HES 130/0.4 6% resulted in diminished creatinine clearance. Differences in kidney function between resuscitation fluids could not be explained by differences in ultrastructural kidney damage.
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| subjects | acute kidney injury fluid therapy HES 130–0.4 septic shock serum albumin |
| title | Effects of resuscitation with human albumin 5%, hydroxyethyl starch 130/0.4 6%, or crystalloid on kidney damage in an ovine model of septic shock |
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