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Effect of a single dose of tobramycin on systemic inflammatory response-induced acute kidney injury in a 6-hour porcine model
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- Lipcsey, Miklós (författare)
- Uppsala universitet,Anestesiologi och intensivvård
- Carlsson, Markus (författare)
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- Larsson, Anders (författare)
- Uppsala universitet,Klinisk kemi
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- (creator_code:org_t)
- 2009
- 2009
- Engelska.
- Ingår i: Critical Care Medicine. - 0090-3493 .- 1530-0293. ; 37:10, s. 2782-2790
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- OBJECTIVE:To evaluate whether the addition of tobramycin further compromises renal function in inflammatory response-induced acute kidney injury. Effective antibiotic treatment in septic shock is crucial for the outcome. The combination of aminoglycosides with different beta-lactam antibiotics offers a broad antimicrobial coverage, rapid bacterial killing, synergistic effects, and low antibiotic-induced endotoxin release. However, aminoglycosides have nephrotoxic effects that may aggravate sepsis-induced acute kidney injury.DESIGN:Prospective, randomized, placebo-controlled experimental study.SETTING:University research unit.SUBJECTS:Twenty-four healthy pigs.INTERVENTIONS:The animals were anesthetized and randomized to four groups. Groups I (n = 8) and II (n = 8) received endotoxin infusion for 6 hrs, whereas groups III (n = 4) and IV (n = 4) received saline. Groups I and III received 7 mg/kg of tobramycin 20 mins after the initiation of the protocol, whereas groups II and IV received saline.MEASUREMENTS AND MAIN RESULTS:The renal elimination rate of a bolus dose of cefuroxime was chosen as the primary end point. Renal function was also evaluated by urine output, creatinine clearance, plasma cystatin C, plasma urea, and urine NAG (N-acetyl-beta-D-glucoaminidase). After 3 hrs, there were significantly lower cefuroxime elimination rates in the two endotoxin groups than in the nonendotoxin groups. No difference in cefuroxime elimination rates between groups I and II could be detected at any time point. Similarly, there were changes indicating acute kidney injury in urine output, creatinine clearance, and plasma cystatin C in the endotoxin groups with no differences between groups I and II. Plasma urea and urine NAG did not differ between any of the groups.CONCLUSIONS:The result of this study does not lend any support to the hypothesis that a single dose of tobramycin enhances the risk of acute renal failure in cases with systemic inflammatory response-induced acute kidney injury.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Nyckelord
- animal model
- aminoglycosides
- kidney failure
- sepsis
- endotoxic shock
- swine
- MEDICINE
- MEDICIN
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- Lipcsey, Miklós
- Carlsson, Markus
- Larsson, Anders
- Algotsson, Lars
- Eriksson, Mats
- Lukinius, Agneta
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- Sjölin, Jan
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