伴有和不伴有24小时静脉注射利多卡因的胃扩张-扭转犬肾生物标志物的浓度和动力学

Concentrations and kinetics of renal biomarkers in dogs with gastric dilatation-volvulus with and without 24-h intravenous lidocaine.

作者信息

Lehmann Anna, Brunner Anna, Marti Eliane, Francey Thierry, Steinbach Sarah, Peters Laureen M, Adamik Katja-Nicole

机构信息

Division of Small Animal Internal Medicine, Department of Clinical Veterinary Science, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

Division of Small Animal Surgery, Department of Clinical Veterinary Science, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

出版信息

Front Vet Sci. 2023 Feb 10;10:1115783. doi: 10.3389/fvets.2023.1115783. eCollection 2023.

DOI:10.3389/fvets.2023.1115783

PMID:36846247

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9953137/

Abstract

BACKGROUND

Gastric dilatation volvulus (GDV) can lead to organ failure including acute kidney injury (AKI). Due to its cytoprotective, antioxidant and anti-inflammatory effects, lidocaine has a potential to prevent AKI in dogs with GDV.

DESIGN AND SETTING

Prospective, observational cohort study in client-owned dogs with GDV.

OBJECTIVE

To determine concentrations of renal biomarkers for AKI in dogs with GDV with and without intravenous (IV) lidocaine therapy.

METHODS

Thirty-two dogs were randomized to receive either IV lidocaine (2 mg/kg, followed by a lidocaine constant rate infusion at a dose of 50 μg/kg/min over 24 h; = 17) or no lidocaine ( = 15). Blood and urine samples were taken at admission ( ) (only blood), during or immediately after surgery ( ), and 24 ( ) and 48 ( ) h after surgery. Plasma creatinine (pCr), plasma neutrophil gelatinase-associated lipocalin (pNGAL), urinary NGAL (uNGAL), uNGAL to creatinine ratio (UNCR), and urinary gamma-glutamyl transferase to creatinine ratio (uGGT/uCr) were evaluated. Biomarker concentrations were compared between dogs with and without IV lidocaine and the course of each marker was determined in comparison to its admission value.

RESULTS

In the entire population, a significantly higher pCr at (median, 95 μmol/L, interquartile range, 82-105) compared with (69 μmol/L, 60-78), (63 μmol/L, 52-78), and (78 μmol/L, 65-87) ( < 0.001) was found. Plasma NGAL increased significantly between (5.66 ng/mL, 3.58-7.43) and (7.50 ng/mL, 4.01-11.89) ( = 0.006) and (9.86 ng/mL, 5.52-13.92) ( < 0.001), respectively. Urinary NGAL increased significantly between (0.61 ng/mL, 0.30-2.59) and (2.62 ng/mL, 1.86-10.92) ( = 0.001) and (4.79 ng/mL, 1.96-34.97 ( < 0.001), respectively. UNCR increased significantly between (0.15 μg/mmol, 0.09-0.54) and (1.14 μg/mmol, 0.41-3.58) ( = 0.0015) and (1.34 μg/mmol, 0.30-7.42) ( < 0.001), respectively. Concentrations of uGGT/uCr increased significantly from highest at (6.20 U/mmol, 3.90-9.90) and significantly decreased at (3.76 U/mmol, 2.84-6.22) ( < 0.001). No significant differences in any renal biomarker concentration were found between dogs with and without IV lidocaine therapy.

CONCLUSION AND CLINICAL RELEVANCE

Plasma NGAL, uNGAL and UNCR remained increased up to 48 h post-surgery. No evidence of lidocaine-associated renoprotection was found.

摘要

背景

胃扩张扭转（GDV）可导致包括急性肾损伤（AKI）在内的器官功能衰竭。利多卡因因其具有细胞保护、抗氧化和抗炎作用，有可能预防患有GDV的犬发生AKI。

设计与环境

对客户拥有的患有GDV的犬进行前瞻性观察队列研究。

目的

确定接受和未接受静脉注射（IV）利多卡因治疗的患有GDV的犬的AKI肾脏生物标志物浓度。

方法

32只犬被随机分为两组，一组接受静脉注射利多卡因（2mg/kg，随后以50μg/kg/min的剂量持续静脉输注24小时；n = 17），另一组不接受利多卡因治疗（n = 15）。在入院时（T0）（仅采集血液）、手术期间或手术后立即（T1）以及手术后24小时（T2）和48小时（T3）采集血液和尿液样本。评估血浆肌酐（pCr）、血浆中性粒细胞明胶酶相关脂质运载蛋白（pNGAL）、尿NGAL（uNGAL）、uNGAL与肌酐比值（UNCR）以及尿γ-谷氨酰转移酶与肌酐比值（uGGT/uCr）。比较接受和未接受静脉注射利多卡因的犬之间的生物标志物浓度，并将每个标志物的变化过程与其入院时的值进行比较。

结果

在整个研究群体中，发现T0时的pCr显著高于T1（中位数，95μmol/L，四分位数间距，82 - 105）、T2（69μmol/L，60 - 78）和T3（78μmol/L，65 - 87）（P < 0.001）。血浆NGAL在T0（5.66ng/mL，3.58 - 7.43）和T1（7.50ng/mL，4.01 - 11.89）（P = 0.006）以及T0和T3（9.86ng/mL，5.52 - 13.92）（P < 0.001）之间分别显著升高。尿NGAL在T0（0.61ng/mL，0.30 - 2.59）和T1（2.62ng/mL，1.86 - 10.92）（P = 0.001）以及T0和T3（4.79ng/mL，1.96 - 34.97）（P < 0.001）之间分别显著升高。UNCR在T0（0.15μg/mmol，0.09 - 0.54）和T1（1.14μg/mmol，0.41 - 3.58）（P = 0.0015）以及T0和T3（1.34μg/mmol，0.30 - 7.42）（P < 0.001）之间分别显著升高。uGGT/uCr的浓度从T0时最高（6.20U/mmol，3.90 - 9.90）开始显著升高，并在T3时显著降低（3.76U/mmol，2.84 - 6.22）（P < 0.001）。接受和未接受静脉注射利多卡因治疗的犬之间，任何肾脏生物标志物浓度均未发现显著差异。