Administração seriada de salina hipertônica 7,5% na terapia para sepse grave decorrente da síndrome da diarreia hemorrágica aguda em cães

Abstract

ABSTRACT.-Barbosa B.C., Freitas P.M.C., Alves F.S., Salvato L.A., Luz M.R., Paes P.R.O., Beier S.L. & Faleiros R.R. 2017. [Serial administration of 7.5% hypertonic saline solution in the therapy of severe sepsis due to acute hemorrhagic diarrhea syndrome in dogs.] Administração seriada de salina hipertônica 7,5% na terapia para sepse grave decorrente da síndrome da diarreia hemorrágica aguda em cães. Pesquisa Veterinária Brasileira 37 (9) The association between acute hemorrhagic diarrhea syndrome and sepsis is frequent in dogs and causes high mortality. In this context we investigated in a randomized single--center controlled trial the late effects of 7.5% hypertonic saline solution in serial applications on hemodynamic, clinical and laboratory variables in dogs with severe sepsis due to the syndrome. Twelve dogs were randomly distributed into two groups of equal numbers, control (CON) and 7.5% hypertonic saline solution (SSH). Clinical and laboratory variables were evaluated immediately after admission of patients (T0), 24 (T24), 48 (T48) and 72 (T72) hours after the admission. The SSH group received Ringer with lactate, antibiotic therapy, analgesic and 5mL/kg -1 bolus of 7.5% SSH over 4 minutes on T24 and T48. The CON group received the same therapy, but instead of 7.5% SSH, Ringer with lactate bolus was given at the same dosis and times. All evaluations were performed prior to the administration of the bolus in both groups. Data collection included complete blood count and clinical variables (AVDN scale, degree of dehydration, respiratory rate and rectal temperature), heart rate (HR) and systolic blood pressure (SBP). Parametric data were evaluated by the Student Newman Keuls and Student t tests, and the nonparametric ones by the Friedman and Mann Whitney test, with a significance level of 0.05. There were no significant differences between the groups and moments in clinical variables. Nevertheless, the SSH group presented a significant elevation of SBP and HR reduction at T72. Hematocrit and hemoglobin concentration decreased in both groups over time. Total leukocyte and monocyte counts showed a significant elevation in the SSH group, however the leukocytes were within the normal range at T72. There were no significant differences in the segmental neutrophils, but a 9.5-fold increase in T72 compared to T24 (P=0.09) in the SSH group was observed, whereas this increase was only 2.5-fold in the CON group (P=0.30). A decrease in platelet counts and globulin concentration was observed in the CON group, while these variables remained stable in the SSH group. In conclusion, serial administration of 7.5% SSH is promising in the therapy of dogs with acute hemorrhagic diarrhea syndrome, since it assists in the stabilization of leukocytes, platelets and globulins in dogs with severe sepsis due to this syndrome.INDEX TERMS: Acute hemorrhagic diarrhea syndrome, dogs, hypertonic saline, severe sepsis, terapy.