Lu Ke1, Paolo Calzavacca2, Michael Bailey3, Clive N May2, Wei-Qin Li4, Joseph Bertolini5, Rinaldo Bellomo3. 1. Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia. rinaldo.bellomo@austin.org.au. 2. Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia. 3. Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia. 4. Surgical Intensive Care Unit, Department of General Surgery, Jinling Hospital, Nanjing, China. 5. CSL Behring, Melbourne, VIC, Australia.
Abstract
BACKGROUND:Solutions with high chloride concentrations, like normal saline (NS), may adversely affect renal blood flow (RBF). We compared the systemic and renal haemodynamic effects of a bolus of NS with those of a novel isotonic solution containing a physiological concentration of chloride and sodium octanoate (SOct) in healthy conscious sheep. METHODS: We performed an experimental double-blind cross-over animal study. After chronic pulmonary and renal artery flow probe insertion, animals were randomly assigned to receive rapid intravenous infusion (1 L over 30 minutes) of either NS or SOct. Haemodynamic parameters were recorded continuously before and after treatment. RESULTS:NS and SOct had similar dilutional effects on the haematocrit. Both induced a short-lived increase in cardiac output (CO) and total peripheral conductance which dissipated by 60 minutes. However, SOct increased RBF more than NS (peak values, 213.4±34.3mL/min v 179.3±35.6mL/min; P < 0.001) with a greater RBF/CO ratio (peak values, 12.2%±3.7% v 10.6%±3.6%; P < 0.001). CONCLUSIONS:NS and SOct appear to have similar systemic haemodynamic effects. However, OS significantly increases RBF compared with normal saline.
RCT Entities:
BACKGROUND: Solutions with high chloride concentrations, like normal saline (NS), may adversely affect renal blood flow (RBF). We compared the systemic and renal haemodynamic effects of a bolus of NS with those of a novel isotonic solution containing a physiological concentration of chloride and sodium octanoate (SOct) in healthy conscious sheep. METHODS: We performed an experimental double-blind cross-over animal study. After chronic pulmonary and renal artery flow probe insertion, animals were randomly assigned to receive rapid intravenous infusion (1 L over 30 minutes) of either NS or SOct. Haemodynamic parameters were recorded continuously before and after treatment. RESULTS: NS and SOct had similar dilutional effects on the haematocrit. Both induced a short-lived increase in cardiac output (CO) and total peripheral conductance which dissipated by 60 minutes. However, SOct increased RBF more than NS (peak values, 213.4±34.3mL/min v 179.3±35.6mL/min; P < 0.001) with a greater RBF/CO ratio (peak values, 12.2%±3.7% v 10.6%±3.6%; P < 0.001). CONCLUSIONS: NS and SOct appear to have similar systemic haemodynamic effects. However, OS significantly increases RBF compared with normal saline.
Authors: Nor'azim Mohd Yunos; Rinaldo Bellomo; Neil Glassford; Harvey Sutcliffe; Que Lam; Michael Bailey Journal: Intensive Care Med Date: 2014-12-18 Impact factor: 17.440