Eficácia da solução de cloreto de sódio a 7,5% com e sem dextran 70 a 6% na preservação da função renal de cães hipovolêmicos submetidos à isquemia-reperfusão

Geraldo Rolim Rodrigues Júnior; José Luiz Gomes do Amaral; Yara Marcondes Machado Castiglia; Mariangela Esther Alencar Marques

doi:10.1590/S0034-70942002000100006

Artigo Científico

Eficácia da solução de cloreto de sódio a 7,5% com e sem dextran 70 a 6% na preservação da função renal de cães hipovolêmicos submetidos à isquemia-reperfusão

Efficacy of 7.5% hypertonic sodium chloride, with and without 6% dextran 70, in renal function preservation of hypovolemic dogs submitted to ischemia-reperfusion

Geraldo Rolim Rodrigues Júnior; José Luiz Gomes do Amaral; Yara Marcondes Machado Castiglia; Mariangela Esther Alencar Marques

http://dx.doi.org/10.1590/S0034-70942002000100006 Braz J Anesthesiol, vol.52, n1, p.41-54, 2002

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Resumo

JUSTIFICATIVA E OBJETIVOS: As soluções hipertônicas de cloreto de sódio, associadas ou não a colóides hiperoncóticos, podem ser eficazes em proteger o rim em situações de hipovolemia. O objetivo deste estudo foi verificar, em cães, o real benefício dessas soluções sobre a função renal, em vigência de hipovolemia e isquemia do órgão. MÉTODO: Em 24 cães, anestesiados com pentobarbital sódico, submetidos à nefrectomia direita e à expansão volêmica com solução de Ringer (1 ml.kg-1.min-1), foram observadas possíveis alterações renais morfo-funcionais após hemorragia de 20 ml.kg-1 e trinta minutos de total isquemia renal esquerda, com posterior reperfusão, além da repercussão renal da administração de soluções de cloreto de sódio 7,5% (SH) e esta em dextran 70 a 6% (SHD). Atributos estudados: FC, PAM, pressão de veia cava inferior, fluxo sangüíneo renal, resistência vascular renal, hematócrito, Na+, K+, osmolaridade plasmática, PaO2, PaCO2 e pH, depuração (para-aminohipurato de sódio - PAH-1, creatinina, osmolar, água livre, Na+, K+), fração de filtração, volume e osmolaridade urinários, excreções urinárias e fracionárias de Na+ e K+ e exame histopatológico do rim. Os atributos foram estudados em três grupos (G1, G2 e G3) e em cinco momentos. RESULTADOS: Houve elevação estatisticamente significativa da pressão arterial média em G2 e G3, da resistência vascular renal em G1, do fluxo sangüíneo renal e da depuração de PAH em G3, da excreção fracionária de Na+ em G2 e G3, das depurações de creatinina, osmolar, de água livre e de Na+ e K+, da excreção urinária de Na+ e K+ e do volume urinário em G3. CONCLUSÕES: A SHD administrada 15 minutos após hemorragia moderada e 30 minutos antes de insulto isquêmico de 30 minutos foi eficiente em proteger o rim de cães das repercussões da isquemia-reperfusão. Não foi constatada alteração histopatológica renal à microscopia óptica.

Palavras-chave

ANIMAL, VOLEMIA, VOLEMIA, VOLEMIA

Abstract

BACKGROUND AND OBJECTIVES: Sodium chloride hypertonic solutions, with or without hyperoncotic colloids, may be effective in protecting kidney against hypovolemia. This experiment aimed at evaluating, in dogs, the real benefit of these solutions on renal function in the presence of hypovolemia and ischemia. METHODS: Experiments were performed in 24 mixed-breed dogs anesthetized with sodium pentobarbital, submitted to right nephrectomy and volume expansion with Ringers solution (1 ml.kg-1.min-1). Renal morphological and physiological changes were studied after 20 ml.kg-1 hemorrhage and 30 min of total left renal ischemia followed by reperfusion, in addition to renal repercussion of 7.5% NaCl (HS) and 7.5% NaCl in 6% dextran 70 (HSD). The following parameters were studied: HR, MBP, inferior vena cava pressure, renal blood flow, renal vascular resistance, hematocrit, Na+, K+, plasma osmolarity, PaO2, PaCO2 and pH; clearance (para-aminohipuric acid - PAH-1, creatinine, free water, osmolar, Na+ and K+), filtration fraction, urine output and osmolarity, sodium and potassium urine and fractionated excretions; rectal temperature; and kidney histopathology. Atributes where studied in five moments in three groups (G1, G2 and G3). RESULTS: There has been a statistically significant increase in mean blood pressure in G2 and G3. RVR was higher in G1; RBF and PAH clearance were higher in G3; Na+ fractionated excretion was increased in G2 and G3; creatinine, free water, osmolar, Na+ and K+ clearances, diuresis, and urinary excretions of Na+ and K+ were higher in G3. CONCLUSIONS: HSD infusion 15 min after mild hemorrhage and 30 min before ischemia was effective in protecting kidney of dogs from ischemia-reperfusion repercussions. There have been no histopathologic changes under optical microscopy.

Keywords

ANIMAL, VOLEMIA, VOLEMIA, VOLEMIA

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Eficácia da solução de cloreto de sódio a 7,5% com e sem dextran 70 a 6% na preservação da função renal de cães hipovolêmicos submetidos à isquemia-reperfusão

Efficacy of 7.5% hypertonic sodium chloride, with and without 6% dextran 70, in renal function preservation of hypovolemic dogs submitted to ischemia-reperfusion

Geraldo Rolim Rodrigues Júnior; José Luiz Gomes do Amaral; Yara Marcondes Machado Castiglia; Mariangela Esther Alencar Marques

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