Effect of intra-abdominal hypertension on plasma exogenous creatinine clearance in conscious and anesthetized dogs.

Min Jang, Won-Gyun Son, Sang-Min Jo, Hyunseok Kim, Chi Won Shin, Inhyung Lee
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引用次数: 4

Abstract

Objective: To evaluate the effect of intra-abdominal pressure (IAP) on plasma exogenous creatinine clearance in both conscious and anesthetized dog models using a balloon technique to generate intra-abdominal hypertension.

Design: Prospective, cross-over, experimental study.

Setting: University-based small animal research facility.

Animals: Six healthy male Beagle dogs.

Interventions: A balloon device comprising a Foley urinary catheter and latex balloon was placed in the intra-abdominal cavity. Plasma exogenous creatinine clearance was compared after intravenous administration of exogenous creatinine solution at 80 mg/kg under 4 different treatment conditions as follows: control and IAP levels of 25 mm Hg in conscious dogs and control and IAP levels of 25 mm Hg in anesthetized dogs (CC, C25, AC, and A25, respectively). Samples were obtained before (T0) and 10, 20, 30, 60, 90, 120, 240, 360, 480, and 600 min after administration of creatinine in all treatment groups.

Measurements and main results: There were no significant differences in plasma creatinine concentration for CC, AC, and C25 during the treatment period. However, in the A25 treatment condition, the plasma creatinine concentration increased significantly at 10, 20, 30, 60, 90, and 120 min after administration of creatinine (P < 0.05). Plasma creatinine clearances were 5.0 ± 0.5, 4.7 ± 1.2, 5.5 ± 0.9, and 2.5 ± 0.5 mL/kg/min for 600 min (CC, AC, C25, and A25, respectively). In the A25 treatment condition, the plasma exogenous creatinine clearance decreased significantly to 50%, 47%, and 55% of that under control conditions (CC, AC, and C25, respectively). After decompression of the abdomen, plasma creatinine concentrations declined rapidly and returned to basal concentrations.

Conclusions: Intra-abdominal hypertension under general anesthesia could cause renal hypoperfusion. Timely decompression may improve the outcome of acutely increased IAP when surgery and/or general anesthesia is required in canine patients.

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腹内高压对清醒和麻醉犬血浆外源性肌酐清除率的影响。
目的:利用球囊法产生腹腔高压,评价腹腔内压(IAP)对清醒和麻醉犬模型血浆外源性肌酐清除率的影响。设计:前瞻性、交叉、实验性研究。环境:以大学为基础的小动物研究机构。动物:6只健康的雄性比格犬。干预措施:在腹腔内放置由Foley导尿管和乳胶气囊组成的气囊装置。在4种不同的处理条件下(分别为CC、C25、AC和A25),静脉给予外源性肌酐溶液80 mg/kg后,比较清醒犬对照和IAP水平为25 mm Hg和麻醉犬对照和IAP水平为25 mm Hg。各组分别于给药前(T0)和给药后10、20、30、60、90、120、240、360、480、600 min取标本。测量和主要结果:治疗期间CC、AC和C25的血浆肌酐浓度无显著差异。而在A25治疗组,肌酐给药后10、20、30、60、90、120 min血浆肌酐浓度显著升高(P < 0.05)。血浆肌酐清除率分别为5.0±0.5、4.7±1.2、5.5±0.9和2.5±0.5 mL/kg/min(分别为CC、AC、C25和A25)。在A25治疗条件下,血浆外源性肌酐清除率显著下降,分别为对照组(CC、AC和C25)的50%、47%和55%。腹部减压后,血浆肌酐浓度迅速下降并恢复到基础浓度。结论:全麻下腹腔高压可引起肾灌注不足。当犬类患者需要手术和/或全身麻醉时,及时减压可以改善急性IAP增加的结果。
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