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High molecular weig...
High molecular weight hyaluronan : a potential adjuvant to fluid resuscitation in abdominal sepsis?
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- Barrueta Tenhunen, Annelie (författare)
- Uppsala universitet,Anestesiologi och intensivvård
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- van der Heijden, Jaap (författare)
- Uppsala universitet,Anestesiologi och intensivvård
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- Dogné, Sophie (författare)
- Molecular Physiology Research Unit (URPhyM), Namur Research Institute for Life Sci-ences (NARILIS), University of Namur (Unamur), Belgium
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- Flamion, Bruno (författare)
- Molecular Physiology Research Unit (URPhyM), Namur Research Institute for Life Sci-ences (NARILIS), University of Namur (Unamur), Belgium
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- Weigl, Wojciech (författare)
- Uppsala universitet,Anestesiologi och intensivvård
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- Frithiof, Robert (författare)
- Uppsala universitet,Anestesiologi och intensivvård
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- Skorup, Paul (författare)
- Uppsala universitet,Infektionsmedicin
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- Larsson, Anders (författare)
- Uppsala universitet,Klinisk kemi
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- Larsson, Anders (författare)
- Uppsala universitet,Anestesiologi och intensivvård
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- Tenhunen, Jyrki (författare)
- Uppsala universitet,Anestesiologi och intensivvård
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(creator_code:org_t)
- Wolters Kluwer, 2023
- 2023
- Engelska.
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Ingår i: Shock. - : Wolters Kluwer. - 1073-2322 .- 1540-0514. ; 59:5, s. 763-770
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- While fluid resuscitation is fundamental in the treatment of sepsis-induced tissue hypo-perfusion, a sustained positive fluid balance is associated with excess mortality. Hyaluronan, an endogenous glycosaminoglycan with high affinity to water, has not been tested previously as adjuvant to fluid resuscitation in sepsis.In a prospective, parallel-grouped, blinded model of porcine peritonitis-sepsis, we randomized animals to intervention with adjuvant hyaluronan (add-on to standard therapy) (n=8) or 0.9% saline (n=8). After the onset of hemodynamic instability the animals received an initial bolus of 0.1 % hyaluronan 1 mg/kg/10 min or placebo (0.9% saline) followed by a continuous infusion of 0.1% hyaluronan (1 mg/kg/h) or saline during the experiment. We hypothesized that the administration of hyaluronan would reduce the volume of fluid administered (aiming at stroke volume variation <13%) and/or attenuate the inflammatory reaction.Total volumes of intravenous fluids infused were 17.5 ± 11 ml/kg/h vs. 19.0 ± 7 ml/kg/h in intervention and control groups, respectively (p = 0.442). Plasma IL-6 increased to 2450 (1420 – 6890) pg/ml and 3690 (1410 – 11960) pg/ml (18 hours of resuscitation) in the intervention and control groups (NS). The intervention counteracted the increase in proportion of fragmented hyaluronan associated with peritonitis-sepsis alone (mean peak elution fraction (18 hours of resuscitation) control group: 17.9 ± 0.6 vs. intervention group: 16.8 ± 0.9 (p = 0.031).In conclusion, hyaluronan did not reduce the volume needed for fluid resuscitation or decrease the inflammatory reaction, even though it counterbalanced the peritonitis induced shift towards increased proportion of fragmented hyaluronan.
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
- peritonitis
- inflammation
- fluid therapy
- colloid
- Anestesiologi och intensivvård
- Anaesthesiology and Intensive Care
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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