Journals / Ulusal Travma ve Acil Cerrahi Dergisi / 2009 / Cilt: 15 - Sayı: 5

Kontrollü ciddi hemorajik şokta replasman sıvılarının böbreklere etkileri: Deneysel araştırma

The renal effect of replacement fluids in controlled severe hemorrhagic shock: An experimental study

Pages
423–432
DOI
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CONCLUSION The 6% HES (130/0.4) did not have any harmful effects on the kidney when it was used alone or in combination with crystalloid for resuscitation of HS in rabbits.

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Objective & Hypothesis:This experimental study examined the effects of resuscitation with Ringer’s lactate (RL), 6% hydroxyethyl starch (130/0.4-HES), and the combination of RL and HES on renal function in hemorrhagic shock (HS).
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Key Findings & Data:METHODS Twenty-four male New Zealand white rabbits weighing 2198-3435 g were divided at random into four groups.
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Conclusion & Impact:CONCLUSION The 6% HES (130/0.4) did not have any harmful effects on the kidney when it was used alone or in combination with crystalloid for resuscitation of HS in rabbits.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Kreatinin · Şok · kanama

Abstract

This experimental study examined the effects of resuscitation with Ringer&#8217;s lactate (RL), 6% hydroxyethyl starch (130/0.4-HES), and the combination of RL and HES on renal function in hemorrhagic shock (HS). METHODS Twenty-four male New Zealand white rabbits weighing 2198-3435 g were divided at random into four groups. HS was constituted by maintaining the mean arterial blood pressure at 30 mmHg and blood lactate at >4 mM/L. Subsequently, Group 1 (control) was not resuscitated, while the study rabbits&#8217; resuscitation was initiated with RL (Group 2), HES (Group 3), or the combination of RL and HES (Group 4). RESULTS In all groups, the serum creatinine and blood urea nitrogen (BUN) levels were observed to be within normal limits, while the lactate dehydrogenase and &#945;-1 microglobulin levels statistically significantly increased when time points were compared with beginning values (p<0.05). Furthermore, cystatin-C levels were observed to be increased after the HS (p<0.05), but returned to the normal level after resuscitation in all the study groups. Interleukin (IL)-6 and tumor necrosis factor (TNF)-&#945; levels were increased in all the rabbits after HS (p<0.05), and there were no significant differences among the study groups after resuscitation (p>0.05). There were no differences in the histological imaging between the groups (p>0.05). CONCLUSION The 6% HES (130/0.4) did not have any harmful effects on the kidney when it was used alone or in combination with crystalloid for resuscitation of HS in rabbits.

Özet

Bu deneysel araştırmada, hemorajik şokta Ringer laktat (RL), %6’lık hidroksietil nişasta (130/0,4-HES) ve RL-HES kombinasyonu ile resüsitasyonun böbrekler üzerine etkileri araştırıldı. GEREÇ VE YÖNTEM Çalışmada ağırlıkları 2198-3435 g olan 24 adet erkek Yeni Zelanda beyaz tavşanı rastgele dört gruba ayrıldı. Hemorajik şok, ortalama arter basıncı 30 mmHg ve kan laktatı >4 mM/L olacak şekilde oluşturuldu. Grup 1’de sıvı replasmanı uygulanmaz iken, Grup 2’de RL, Grup 3’te HES ve Grup 4’te de RL+HES ile sıvı replasmanı ile şok düzeltildi. BULGULAR Bütün gruplarda, serum kreatinin ve kan üre azotu düzeyleri hemorajik şoktan ve sıvı resüsitasyonundan sonra normal sınırlarda kaldı. Laktat dehidrogenaz ve a-1 mikroglobulin düzeyleri şoktan ve sıvı resüsitasyonundan sonra anlamlı olarak arttı (p 0,05). Sistatin-C düzeyleri şoktan sonra artmasına karşın (p 0,05). Böbreklerin histopatolojik incelemelerinde gruplar arasında bir fark bulunmadı (p>0,05). SONUÇ %6’lık HES (130/0,4), gerek tek başına gerekse RL ile beraber hemorajik şokun tedavisinde kullanıldığında tavşan böbrekleri üzerine zararlı bir etkisi olmadı.

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Cite This Article

ADANIR, T., AKSUN, M., CİRİT, M., TAŞLI, A. F., ŞAHİN, O., KESTELLİ, M., KANTAROĞLU, A. T., KÖSEOĞLU, M., ŞENCAN, A., KARAHAN, N. (2009). Kontrollü ciddi hemorajik şokta replasman sıvılarının böbreklere etkileri: Deneysel araştırma. Ulusal Travma ve Acil Cerrahi Dergisi, Cilt: 15 - Sayı: 5, 423–432. https://ajindex.com/articles/324349

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