Fluid restrictive resuscitation with high molecular weight hyaluronan infusion in early peritonitis sepsis

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Fältnamn	Indikatorer	Metadata
000		04830naa a2200481 4500
001		oai:DiVA.org:uu-494128
003		SwePub
008		230115s2023 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4941282 URI
024	7	a https://doi.org/10.1186/s40635-023-00548-w2 DOI
040		a (SwePub)uu
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Barrueta Tenhunen, Annelieu Uppsala universitet,Anestesiologi och intensivvård4 aut0 (Swepub:uu)annba203
245	1 0	a Fluid restrictive resuscitation with high molecular weight hyaluronan infusion in early peritonitis sepsis
264	1	b Springer Nature,c 2023
338		a electronic2 rdacarrier
500		a Title in the list of papers of Annelie Barrueta Tenhunen's thesis: Fluid restrictive resuscitation with high molecular weight hyaluronan infusion in early peritonitis-sepsis
520		a Sepsis is a condition with high morbidity and mortality. Prompt recognition and initiation of treatment is essential. Despite forming an integral part of sepsis management, fluid resuscitation may also lead to volume overload, which in turn is associated with increased mortality. The optimal fluid strategy in sepsis resuscitation is yet to be defined. Hyaluronan, an endogenous glycosaminoglycan with high affinity to water is an important constituent of the endothelial glycocalyx. We hypothesized that exogenously administered hyaluronan would counteract intravascular volume depletion and contribute to endothelial glycocalyx integrity in a fluid restrictive model of peritonitis. In a prospective, blinded model of porcine peritonitis sepsis, we randomized animals to intervention with hyaluronan (n = 8) or 0.9% saline (n = 8). The animals received an infusion of 0.1% hyaluronan 6 ml/kg/h, or the same volume of saline, during the first 2 h of peritonitis. Stroke volume variation and hemoconcentration were comparable in the two groups throughout the experiment. Cardiac output was higher in the intervention group during the infusion of hyaluronan (3.2 ± 0.5 l/min in intervention group vs 2.7 ± 0.2 l/min in the control group) (p = 0.039). The increase in lactate was more pronounced in the intervention group (3.2 ± 1.0 mmol/l in the intervention group and 1.7 ± 0.7 mmol/l in the control group) at the end of the experiment (p < 0.001). Concentrations of surrogate markers of glycocalyx damage; syndecan 1 (0.6 ± 0.2 ng/ml vs 0.5 ± 0.2 ng/ml, p = 0.292), heparan sulphate (1.23 ± 0.2 vs 1.4 ± 0.3 ng/ml, p = 0.211) and vascular adhesion protein 1 (7.0 ± 4.1 vs 8.2 ± 2.3 ng/ml, p = 0.492) were comparable in the two groups at the end of the experiment. In conclusion, hyaluronan did not counteract intravascular volume depletion in early peritonitis sepsis. However, this finding is hampered by the short observation period and a beneficial effect of HMW-HA in peritonitis sepsis cannot be discarded based on the results of the present study.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Anestesi och intensivvård0 (SwePub)302012 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Anesthesiology and Intensive Care0 (SwePub)302012 hsv//eng
653		a animal model
653		a inflammation
653		a glycocalyx
653		a fluid therapy
653		a colloid
653		a Anestesiologi och intensivvård
653		a Anaesthesiology and Intensive Care
700	1	a van der Heijden, Jaapu Uppsala universitet,Anestesiologi och intensivvård4 aut0 (Swepub:uu)jaaho800
700	1	a Skorup, Paulu Uppsala universitet,Infektionsmedicin4 aut0 (Swepub:uu)pausk660
700	1	a Maccarana, Marcou Uppsala universitet,Institutionen för medicinsk biokemi och mikrobiologi4 aut0 (Swepub:uu)marma713
700	1	a Larsson, Andersu Uppsala universitet,Klinisk kemi4 aut0 (Swepub:uu)andlarss
700	1	a Larsson, Andersu Uppsala universitet,Hedenstiernalaboratoriet4 aut0 (Swepub:uu)andla606
700	1	a Perchiazzi, Gaetanou Uppsala universitet,Hedenstiernalaboratoriet4 aut0 (Swepub:uu)gpe24447
700	1	a Tenhunen, Jyrkiu Uppsala universitet,Anestesiologi och intensivvård4 aut0 (Swepub:uu)jyrte348
710	2	a Uppsala universitetb Anestesiologi och intensivvård4 org
773	0	t Intensive Care Medicine Experimentald : Springer Natureg 11:1q 11:1x 2197-425X
856	4	u https://doi.org/10.1186/s40635-023-00548-wy Fulltext
856	4	u https://uu.diva-portal.org/smash/get/diva2:1727102/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-494128
856	4 8	u https://doi.org/10.1186/s40635-023-00548-w

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