Lars Witt1, Silke Glage2, Ralf Lichtinghagen3, Lars Pape4, Dietmar Boethig5, Nils Dennhardt1, Sebastian Heiderich1, Andreas Leffler1, Robert Sümpelmann1. 1. Clinic of Anaesthesiology, Hanover Medical School, Hanover, Germany. 2. Institute of Laboratory Animal Science and Experimental Pathology, Hanover Medical School, Hanover, Germany. 3. Institute for Clinical Chemistry, Hanover Medical School, Hanover, Germany. 4. Department of Paediatric Nephrology, Hanover Medical School, Hanover, Germany. 5. Department for Paediatric Cardiology and Intensive Care, Hanover Medical School, Hanover, Germany.
Abstract
OBJECTIVES: Despite serious renal side effects in critically ill adult patients, artificial colloids are still fundamental components of perioperative fluid therapy in infants and children, although the impact of 6% hydroxyethyl starch (HES) and 4% gelatin (GEL) on renal function during pediatric surgery has not been identified yet. AIM: To determine the impact of high doses of artificial colloids on renal function, we conducted an experimental animal study and hypothesized that neither the infusion of HES nor of GEL would have a serious impact on renal function. METHODS: Fifteen sedated piglets were randomly assigned to receive an infusion of either 50 ml · kg(-1) HES or GEL, or a balanced electrolyte solution (crystalloid group). Before and 1 week after infusion, serum and urine renal function tests were recorded and renal biopsies were taken. RESULTS: Serum and urine renal function tests revealed no increase after administration of HES and GEL, and only a discrete increase in serum creatinine (median 9.8 μmol · l(-1), 95% CI 4.0-19.1) in the crystalloid group. Histopathological examination indicated a sparsely, multifocal infiltration of mononuclear cells in all groups and an unspecific pyelectasia of one animal in the GEL group. CONCLUSIONS: After high doses of HES or GEL in piglets, no relevant impact on renal function could be found. These results confirm that AKI after HES or GEL is very unlikely in hemodynamically stable perioperative patients with normal renal function.
OBJECTIVES: Despite serious renal side effects in critically ill adult patients, artificial colloids are still fundamental components of perioperative fluid therapy in infants and children, although the impact of 6% hydroxyethyl starch (HES) and 4% gelatin (GEL) on renal function during pediatric surgery has not been identified yet. AIM: To determine the impact of high doses of artificial colloids on renal function, we conducted an experimental animal study and hypothesized that neither the infusion of HES nor of GEL would have a serious impact on renal function. METHODS: Fifteen sedated piglets were randomly assigned to receive an infusion of either 50 ml · kg(-1) HES or GEL, or a balanced electrolyte solution (crystalloid group). Before and 1 week after infusion, serum and urine renal function tests were recorded and renal biopsies were taken. RESULTS: Serum and urine renal function tests revealed no increase after administration of HES and GEL, and only a discrete increase in serum creatinine (median 9.8 μmol · l(-1), 95% CI 4.0-19.1) in the crystalloid group. Histopathological examination indicated a sparsely, multifocal infiltration of mononuclear cells in all groups and an unspecific pyelectasia of one animal in the GEL group. CONCLUSIONS: After high doses of HES or GEL in piglets, no relevant impact on renal function could be found. These results confirm that AKI after HES or GEL is very unlikely in hemodynamically stable perioperative patients with normal renal function.
Authors: Alexander Ziebart; Christian Möllmann; Andreas Garcia-Bardon; Jens Kamuf; Moritz Schäfer; Rainer Thomas; Erik K Hartmann Journal: Scand J Trauma Resusc Emerg Med Date: 2018-02-09 Impact factor: 2.953
Authors: Julia Werner; Oliver Hunsicker; Anja Schneider; Henryk Stein; Christian von Heymann; Adrian Freitag; Aarne Feldheiser; Klaus-Dieter Wernecke; Claudia Spies Journal: Medicine (Baltimore) Date: 2018-04 Impact factor: 1.889
Authors: Alexander Ziebart; Robert Ruemmler; Christian Möllmann; Jens Kamuf; Andreas Garcia-Bardon; Serge C Thal; Erik K Hartmann Journal: PeerJ Date: 2020-02-10 Impact factor: 2.984