Effect of peri-operative crystalloid fluid rate on circulating hyaluronan in healthy dogs: A pilot study
Effect of peri-operative crystalloid fluid rate on circulating hyaluronan in healthy dogs: A pilot study
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DOI：
10.1016/j.tvjl.2020.105578
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发表时间：
2021-01-01
影响因子：
2.2
通讯作者：
Jeffery, U.
中科院分区：
文献类型：
--
作者：
Beiseigel, M.;Simon, B. T.;Jeffery, U.
血容量过多会损害内皮糖萼，这是血管通透性、凝血和炎症的关键调节因子。对于接受择期手术的健康犬，建议初始围手术期晶体液速率为5 mL/kg/h，但通常继续使用更高速率。本研究旨在确定在接受择期外科手术的全身健康犬中，较高的开始围手术期液体速率是否与透明质酸的血浆浓度的较大增加相关，透明质酸是与糖萼损伤相关的标志物。38只接受卵巢子宫切除术或去势术的犬被随机分配接受乳酸林格氏液，起始围手术期液体速率为10 mL/kg/d。h（n = 19）或5 mL/kg/h（n = 19）。通过ELISA法测定液体治疗前后样本中的血浆透明质酸浓度。在围手术期补液之前（基线，P= 0.52）或之后（P= 0.62），两组之间的透明质酸值无显著差异。与相应的基线值相比，5和10 ml/kg/h液体给药后透明质酸值显著增加（两种比较的P=0.02）。该初步研究发现，在低流速和高流速的液体治疗过程中，透明质酸增加。一种可能的解释是，两种液体速率都有助于糖萼破坏，但应该强调的是，透明质酸对糖萼不是特异性的。需要进一步的研究来确定循环透明质酸增加的起源及其在接受择期手术的犬中的临床意义。(C)2020爱思唯尔有限公司保留所有权利。
Hypervolemia can damage the endothelial glycocalyx, a key regulator of vascular permeability, coagulation and inflammation. A starting peri-operative crystalloid fluid rate of 5 mL/kg/h is recommended for healthy dogs undergoing elective procedures but higher rates continue to be commonly used. This study aimed to determine if a higher starting perioperative fluid rate was associated with a greater increase in plasma concentrations of hyaluronan, a marker correlated with glycocalyx damage, in systemically healthy dogs undergoing elective surgical procedures.Based on a sample size calculation, 38 dogs undergoing ovariohysterectomy or castration were randomly assigned to receive lactated Ringer's at a starting perioperative fluid rate of 10 mL/kg/h (n = 19) or 5 mL/kg/h (n = 19). Plasma hyaluronan concentrations were measured by ELISA in pre- and post-fluid therapy samples. There were no significant differences between groups in hyaluronan values before (baseline, P= 0.52) or after perioperative fluid administration (P= 0.62). Compared to respective baseline values, hyaluronan values significantly increased following 5 and 10 ml/kg/h fluid administration (P=0.02 for both comparisons). This preliminary study identified an increase in hyaluronan over the course of fluid therapy with both the low and high fluid rate. One possible explanation is that both fluid rates contribute to glycocalyx disruption, but it should be emphasized that hyaluronan is not specific to the glycocalyx. Further studies are needed to determine the origin of the increased circulating hyaluronan and its clinical significance in dogs undergoing elective surgical procedures. (C) 2020 Elsevier Ltd. All rights reserved.