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出血及乳酸林格氏液或130/0.4 万汶复苏对猫胶体渗透压和渗透压的影响

Effects of haemorrhage and lactated Ringer's solution or tetrastarch 130/0.4 resuscitation on colloidal osmotic pressure and osmolality in cats.

作者信息

Michaletos Anthea, Breytenbach Marinell, Zeiler Gareth E

机构信息

Valley Farm Animal Hospital, Faerie Glen, Pretoria, Gauteng, South Africa.

Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, South Africa.

出版信息

J Feline Med Surg. 2025 Apr;27(4):1098612X251320299. doi: 10.1177/1098612X251320299. Epub 2025 Apr 4.

Abstract

ObjectivesTo determine the effects of haemorrhage and fluid over-resuscitation on colloidal osmotic pressure of albumin (COP albumin), plasma (Posm) and effective (Eosm) osmolality in anaesthetised cats.MethodsA total of six cats were given three treatments once, at 2-month intervals, in a randomised, crossover haemorrhage-resuscitation study. The treatments were divided into two phases, a controlled haemorrhage phase and a fluid resuscitation phase, as follows: (1) NoHR = no controlled haemorrhage and no resuscitation; (2) LRS = controlled haemorrhage followed by lactated Ringer's solution infusion (60 ml/kg/h); and (3) TS = controlled haemorrhage followed by 6% tetrastarch 130/0.4 suspended in 0.9% saline infusion (20 ml/kg/h). The resuscitation fluids were administered for 120 mins. Data were collected before haemorrhage, before resuscitation and at 30 min intervals until 120 mins. Variables were calculated at each time point as follows: COP albumin = albumin concentration (g/l) × 0.57; Posm = (2 × sodium) + glucose + blood urea nitrogen; and Eosm = (2 × sodium) + glucose. All Posm and Eosm concentrations were measured as mmol/l. Data were compared using a general linear mixed model (significance: <0.05).ResultsMean ± SD total haemorrhage volumes for NoHR, LRS and TS were 10.2 ± 2.3, 29.3 ± 9.0 and 29.1 ± 6.3 ml/kg, respectively. The COP albumin decreased over time in all treatments regardless of volumes of blood lost and fluid administered. The decrease in COP albumin was profound and clinically relevant in LRS and TS (both <0.001). There were no statistical differences in Posm and Eosm over time except in LRS at 90 ( = 0.004) and 120 ml/kg ( <0.001).Conclusions and relevanceThe COP albumin decreased in all treatments but to low and clinically relevant concentrations in LRS and TS, putting the cats at risk of fluid overload. There were no clinically relevant derangements in Posm and Eosm.

摘要

目的

确定出血和液体过度复苏对麻醉猫白蛋白胶体渗透压(COP白蛋白)、血浆渗透压(Posm)和有效渗透压(Eosm)的影响。

方法

在一项随机交叉出血-复苏研究中,总共6只猫每隔2个月接受一次三种治疗。治疗分为两个阶段,即控制性出血阶段和液体复苏阶段,如下:(1)NoHR = 无控制性出血且无复苏;(2)LRS = 控制性出血后输注乳酸林格氏液(60 ml/kg/h);(3)TS = 控制性出血后输注6% 130/0.4的羟乙基淀粉(贺斯),悬浮于0.9%盐水中(20 ml/kg/h)。复苏液输注120分钟。在出血前、复苏前以及直到120分钟每隔30分钟收集数据。每个时间点的变量计算如下:COP白蛋白 = 白蛋白浓度(g/l)×0.57;Posm =(2×钠)+葡萄糖+血尿素氮;Eosm =(2×钠)+葡萄糖。所有Posm和Eosm浓度均以mmol/l为单位测量。使用一般线性混合模型比较数据(显著性:<0.05)。

结果

NoHR、LRS和TS的平均±标准差总出血量分别为10.2±2.3、29.3±9.0和29.1±6.3 ml/kg。无论失血量和给予的液体量如何,所有治疗中COP白蛋白均随时间下降。LRS和TS中COP白蛋白的下降幅度很大且具有临床相关性(均<0.001)。除LRS在90(P = 0.004)和120 ml/kg(<0.001)时外,Posm和Eosm随时间无统计学差异。

结论及相关性

所有治疗中COP白蛋白均下降,但LRS和TS中降至较低且具有临床相关性的浓度,使猫有液体过载风险。Posm和Eosm无临床相关紊乱。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6f4/11970108/4744c28a3c9f/10.1177_1098612X251320299-fig1.jpg

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