Sodium lactate improves renal microvascular thrombosis compared to sodium bicarbonate and 0.9% NaCl in a porcine model of endotoxic shock: an experimental randomized open label controlled study.
Sodium lactate improves renal microvascular thrombosis compared to sodium bicarbonate and 0.9% NaCl in a porcine model of endotoxic shock: an experimental randomized open label controlled study.
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DOI：
10.1186/s13613-018-0367-9
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发表时间：
2018-02-14
影响因子：
8.1
通讯作者：
Favory R
中科院分区：
文献类型：
--
作者：
Duburcq T;Durand A;Tournoys A;Gnemmi V;Gmyr V;Pattou F;Jourdain M;Tamion F;Besnier E;Préau S;Parmentier-Decrucq E;Mathieu D;Poissy J;Favory R
乳酸钠似乎改善了液体平衡，避免了液体超负荷。本研究的目的是确定这些有益作用是否可以至少部分地通过改善弥散性血管内凝血（DIC）相关的肾微血管血栓形成来解释。一项干预性随机开放标签对照实验研究的辅助工作。15头雌性“大白色”猪（2月龄）用静脉输注E.大肠杆菌内毒素。将三组动物（每组5只）随机分配接受不同的液体：治疗组接受11.2%乳酸钠（SL组）;等渗对照组接受0.9% NaCl（NC组）;高渗对照组接受8.4%碳酸氢钠（SB组），渗透压摩尔和钠量与SL组相同。在5小时内测量肾小球滤过率（GFR）标志物、凝血和炎症参数。安乐死后立即取出肾脏进行组织学研究。采用非参数检验和Dunn校正进行多重比较的统计分析。p < 0.05被认为是显著的。直接免疫荧光研究显示，SL组[5（0-28）%]中肾小球中血栓形成的毛细血管切片百分比显著低于NC组[64（43-79）%，p = 0.01]和SB组[64（43-79），p = 0.03]。血小板计数和纤维蛋白原水平的改变发生得更早，并且在两个对照组中与SL组相比显著更明显（在210和300分钟时p < 0.05）。NC组[754（367-945）μg/mL; p = 0.03]和SB组[463（249-592）μg/mL; p = 0.03]中凝血酶-抗凝血酶复合物的增加显著高于SL组[176（37-265）μg/mL]。实验结束时，SL组的肌酐清除率[55.46（30.07-67.85）mL/min]显著高于NC组[1.52（0.17-27.67）mL/min，p = 0.03]。在这项研究中，我们报告说，乳酸钠改善DIC相关的肾微血管血栓形成和保护GFR。这些发现至少可以部分解释乳酸钠输注后观察到的更好的液体平衡。
Sodium lactate seemed to improve fluid balance and avoid fluid overload. The objective of this study was to determine if these beneficial effects can be at least partly explained by an improvement in disseminated intravascular coagulation (DIC)-associated renal microvascular thrombosis. Ancillary work of an interventional randomized open label controlled experimental study. Fifteen female “Large White” pigs (2 months old) were challenged with intravenous infusion of E. coli endotoxin. Three groups of five animals were randomly assigned to receive different fluids: a treatment group received sodium lactate 11.2% (SL group); an isotonic control group received 0.9% NaCl (NC group); a hypertonic control group, with the same amount of osmoles and sodium than SL group, received sodium bicarbonate 8.4% (SB group). Glomerular filtration rate (GFR) markers, coagulation and inflammation parameters were measured over a 5-h period. Immediately after euthanasia, kidneys were withdrawn for histological study. Statistical analysis was performed with nonparametric tests and the Dunn correction for multiple comparisons. A p < 0.05 was considered significant. The direct immunofluorescence study revealed that the percentage of capillary sections thrombosed in glomerulus were significantly lesser in SL group [5 (0–28) %] compared to NC [64 (43–79) %, p = 0.01] and SB [64 (43–79), p = 0.03] groups. Alterations in platelet count and fibrinogen level occurred earlier and were significantly more pronounced in both control groups compared to SL group (p < 0.05 at 210 and 300 min). The increase in thrombin–antithrombin complexes was significantly higher in NC [754 (367–945) μg/mL; p = 0.03] and SB [463 (249–592) μg/mL; p = 0.03] groups than in SL group [176 (37–265) μg/mL]. At the end of the experiment, creatinine clearance was significantly higher in SL group [55.46 (30.07–67.85) mL/min] compared to NC group [1.52 (0.17–27.67) mL/min, p = 0.03]. In this study, we report that sodium lactate improves DIC-associated renal microvascular thrombosis and preserves GFR. These findings could at least partly explain the better fluid balance observed with sodium lactate infusion.
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DOI：
10.1136/bmj.f839
发表时间：
2013-02-15
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Haase N;Perner A;Hennings LI;Siegemund M;Lauridsen B;Wetterslev M;Wetterslev J
通讯作者：
Wetterslev J
DOI：
10.1186/s13054-017-1694-1
发表时间：
2017-05-19
期刊：
Critical care (London, England)
影响因子：
--
作者：
Duburcq T;Durand A;Dessein AF;Vamecq J;Vienne JC;Dobbelaere D;Mention K;Douillard C;Maboudou P;Gmyr V;Pattou F;Jourdain M;Tamion F;Poissy J;Mathieu D;Favory R
通讯作者：
Favory R
DOI：
10.1097/00005373-199807000-00002
发表时间：
1998-07-01
影响因子：
--
作者：
Angle, N;Hoyt, DB;Junger, WG
通讯作者：
Junger, WG
影响因子：
3.1
作者：
Duburcq, Thibault;Tournoys, Antoine;Jourdain, Merce
通讯作者：
Jourdain, Merce
影响因子：
8.8
作者：
Bakhtiari, K;Meijers, JCM;Levi, M
通讯作者：
Levi, M