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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 (author)
- Uppsala universitet,Anestesiologi och intensivvård
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- van der Heijden, Jaap (author)
- Uppsala universitet,Anestesiologi och intensivvård
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- Dogné, Sophie (author)
- Molecular Physiology Research Unit (URPhyM), Namur Research Institute for Life Sci-ences (NARILIS), University of Namur (Unamur), Belgium
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- Flamion, Bruno (author)
- Molecular Physiology Research Unit (URPhyM), Namur Research Institute for Life Sci-ences (NARILIS), University of Namur (Unamur), Belgium
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- Weigl, Wojciech (author)
- Uppsala universitet,Anestesiologi och intensivvård
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- Frithiof, Robert (author)
- Uppsala universitet,Anestesiologi och intensivvård
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- Skorup, Paul (author)
- Uppsala universitet,Infektionsmedicin
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- Larsson, Anders (author)
- Uppsala universitet,Klinisk kemi
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- Larsson, Anders (author)
- Uppsala universitet,Anestesiologi och intensivvård
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- Tenhunen, Jyrki (author)
- Uppsala universitet,Anestesiologi och intensivvård
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(creator_code:org_t)
- Wolters Kluwer, 2023
- 2023
- English.
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In: Shock. - : Wolters Kluwer. - 1073-2322 .- 1540-0514. ; 59:5, s. 763-770
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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Abstract
Subject headings
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- animal model
- peritonitis
- inflammation
- fluid therapy
- colloid
- Anestesiologi och intensivvård
- Anaesthesiology and Intensive Care
Publication and Content Type
- ref (subject category)
- art (subject category)
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