Hemodynamic effects of volume replacement with saline solution and hypertonic hydroxyethyl starch in dogs

Abstract

Purpose: To investigate hemodynamic response to volume replacement with saline solution and hypertonic hydroxyethyl starch in hypovolemic dogs. Methods: Forty dogs under general anesthesia and hemodynamic monitoring, following measurements at baseline, were bled 20 ml.Kg -1 and parameters were measured again after 10 minutes. The animals were randomly divided in two groups and volume replacement was performed with saline solution twice the volume removed or 4 ml.Kg -1 of hypertonic hydroxyethyl starch. Hemodynamic data were again measured after 5, 15, 30, 45 and 60 minutes. Results: With both solutions values returned to satisfactory hemodynamic levels. With saline solution, there was a greater amplitude in variations that tended to decrease progressively. With hypertonic hydroxyethyl starch, the parameters studied returned more rapidly to levels similar to those at baseline and varied less. Conclusion: Both solutions proved to be efficient at replacing volume in the short period studied, although hypertonic hydroxyethyl starch produced more stable results. Key words: Hemodynamics. Hypovolemia. Hetastarch. Saline Solution, Hypertonic. Dogs. RESUMOObjetivo: Avaliar em cães hipovolêmicos as respostas hemodinâmicas da reposição volêmica com solução salina e hidroxi-etil amido hipertônico. Métodos: Quarenta cães sob anestesia geral e monitorização hemodinâmica, após medidas em repouso foram sangrados 20 ml.Kg -1 e tiveram os parâmetros novamente medidos após 10 minutos. Os animais foram aleatoriamente divididos em dois grupos nos quais foi realizada reposição volêmica com solução fisiológica duas vezes o volume retirado ou 4 ml.Kg -1 de hidroxi-etil amido hipertônico e os dados hemodinâmicos medidos novamente após 5, 15, 30, 45 e 60 minutos. Resultados: A reposição volêmica com as duas soluções fez os valores retornarem a níveis hemodinâmicos satisfatórios, a amplitude das variações com solução fisiológica foi maior, mas tendeu a diminuir progressivamente, com o hidroxi-etil amido hipertônico os parâmetros estudados retornaram a semelhantes ao repouso mais rapidamente e variaram menos. Conclusão: Ambas soluções se mostraram eficientes na reposição volêmica, o hidroxi-etil amido hipertônico proporcionou resultados mais estáveis.

Retrospective evaluation of the effects of administration of tetrastarch (hydroxyethyl starch 130/0.4) on plasma creatinine concentration in dogs (2010–2013): 201 dogs

“…Nevertheless, the greater availability of HES compared to animal blood products, and safety concerns regarding the use of human albumin as an alternative in animals 17 make it difficult to replace HES in veterinary medicine. Evidence regarding the safety and efficacy of HES in small animals is restricted to studies of small numbers of animals and mostly experimental data, [18][19][20][21][22][23][24][25][26][27][28] and the effect of HES on canine renal function in naturally occurring kidney disease has not been thoroughly investigated. Indeed, the few published studies evaluating hospital-acquired renal failure in small animals did not assess possible associations with HES administration.…”

Comparison of the in vitro effects of saline, hypertonic hydroxyethyl starch, hypertonic saline, and two forms of hydroxyethyl starch on whole blood coagulation and platelet function in dogs

“…The concept of small volume resuscitation using hypertonic solutions involves the rapid infusion of a small dose (4 mL/kg body weight) of 7.2% hypertonic saline solution (HTS) or 7.2% HTS/colloid solution for primary resuscitation in trauma or shock patients . The rationale to this therapy is based on the instantaneous mobilization of endogenous fluids along osmotic gradients from the intracellular to the intravascular compartments, and is widely used in human medicine .…”

“…The rationale to this therapy is based on the instantaneous mobilization of endogenous fluids along osmotic gradients from the intracellular to the intravascular compartments, and is widely used in human medicine . In addition, resuscitation with hypertonic solutions has been extensively investigated in a variety of laboratory and clinical studies in dogs with hemorrhagic shock, and has been shown to have beneficial effects on circulatory parameters, microvascular perfusion, and oxygen delivery . Further studies have shown hypertonic solutions to be effective in resuscitation of endotoxic and septic shock, and shock associated with gastric dilation‐volvulus, as well as in decreasing intracranial pressure when hemorrhagic shock was associated with intracranial hypertension in dogs .…”

Hydroxyethyl starches in equine medicine

“…In conclusion, limited evidence endorses the superiority of volume expansion effects of HES over crystalloids in horses, and effects seem less apparent in diseased horses than in healthy horses. Corroborating on previous animal studies, [109][110][111][112] also in horses the combination of HES with hypertonic saline failed to show additional benefits on cardiovascular and pulmonary effects over administration of crystalloids. 103…”