Sistemik yangısal yanıt sendromlu bir köpekte %7.2’lik hipertonik salin solüsyonunun ekokardiyografik parametreler üzerine etkisi

Year 2023, Volume: 16 Issue: 2, 241 - 247, 30.06.2023

Nilay Arslan , Cansu Balıkçı , Songül Erdoğan , Hasan Erdoğan , Kerem Ural

https://doi.org/10.30607/kvj.1218493

Abstract

Biz bu olgu sunumuyla sistemik inflamatuar yanıt sendromu (SIRS) gelişmiş 5 aylık, erkek, Kangal Çoban melezi bir köpekte %7.2 hipertonik salin infüzyonunun ekokardiyografik parametreler üzerine etkisinin değerlendirilmesi amaçladık. Bu kapsamda olgu kliniğe ilk başvurduğunda SIRS klinik ve laboratuvar bulguları ile tanımlandı. Sıvı replasmanı için %7.2 hipertonik salin, 4 ml/kg dozda (1.6 ml/kg/dak) intravenöz yolla uygulandı. Ekokardiyografi sıvı infüzyonundan önce (t=0. dk), ve sonra (t=5., 15. dk) gerçekleştirildi. Köpekte %7.2'lik hipertonik salin uygulaması sonrasında sistolik fonksiyonda, kardiyak kontraktilitede ve sol ventrikül ön yükünde artış belirlendi. Bu olgu dikkate alındığında 4 ml/kg %7.2 hipertonik salin solüsyonu infüzyonun sistolik disfonksiyonu düzenlediği belirlendi.

Keywords

Hipertonik salin solusyonu, sol ventrikül fonksiyonu, M-mod ekokardiyografi, sistemik inflamatuar yanıt sendromu

The Efficiency of 7.2% Hypertonic Saline Solution on Echocardiographic Parameters in a Dog with Systemic Inflammatory Response Syndrome

Abstract

We were aimed with this case report that evaluate the efficiency of 7.2% hypertonic saline infusion on echocardiographic parameters in a 5-months-old male Kangal Shepherd crossbreed dog with the systemic inflammatory response syndrome (SIRS). For this propose on initial referral to the clinic, SIRS was defined with clinical and laboratory finding. Hypertonic saline (7.2%) was administered at intravenously of 4 ml.kg-1 (1.6 ml.kg-1.min-1) for fluid replacement. Echocardiography was performed at before (t=0 min), and after (t=5, t=15 min) fluid infusion. An increase in systolic function, cardiac contractility and left ventricular preload in the dog were determineted with the administration of 7.2% hypertonic saline. Considering this case, systolic dysfunction was improved by infusion of 4 ml.kg-1 7.2% hypertonic saline solution.

Keywords

Hypertonic saline solution, left ventricular function, M-mode echocardiography, systemic inflammatory response syndrome

References

• Agarwal, R., Bouldin, J. M., Light, R. P., & Garg, A. (2011). Inferior vena cava diameter and left atrial diameter measure volume but not dry weight. Clinical journal of the American Society of Nephrology : CJASN, 6(5), 1066–1072. https://doi.org/10.2215/CJN.09321010
• Baue, A. E., Tragus, E. T., & Parkins, W. M. (1967). A comparison of isotonic and hypertonic solutions and blood on blood flow and oxygen consumption in the initial treatment of hemorrhagic shock. The Journal of trauma, 7(5), 743–756. https://doi.org/10.1097/00005373-196709000-00012
• Bauer, N., & Moritz, A. (2013). Coagulation response in dogs with and without systemic inflammatory response syndrome - preliminary results. Research in veterinary science, 94(1), 122–131. https://doi.org/10.1016/j.rvsc.2012.07.029
• Ben-Haim, S. A., Edoute, Y., Hayam, G., & Better, O. S. (1992). Sodium modulates inotropic response to hyperosmolarity in isolated working rat heart. The American journal of physiology, 263(4 Pt 2), H1154–H1160. https://doi.org/10.1152/ajpheart.1992.263.4.H1154
• Bone, R. C., Balk, R. A., Cerra, F. B., Dellinger, R. P., Fein, A. M., Knaus, W. A., Schein, R. M., & Sibbald, W. J. (1992). Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest, 101(6), 1644–1655. https://doi.org/10.1378/chest.101.6.1644
• Brown, J. M., Grosso, M. A., & Moore, E. E. (1990). Hypertonic saline and dextran: impact on cardiac function in the isolated rat heart. The Journal of trauma, 30(6), 646–651.
• Campbell, F. E., & Kittleson, M. D. (2007). The effect of hydration status on the echocardiographic measurements of normal cats. Journal of veterinary internal medicine, 21(5), 1008–1015. https://doi.org/10.1892/0891-6640(2007)21[1008:teohso]2.0.co;2
• Constable, P. D., Muir, W. W., 3rd, & Binkley, P. F. (1994). Hypertonic saline is a negative inotropic agent in normovolumic dogs. The American journal of physiology, 267(2 Pt 2), H667–H677. https://doi.org/10.1152/ajpheart.1994.267.2.H667
• DeMaria, A. N., Neumann, A., Schubart, P. J., Lee, G., & Mason, D. T. (1979). Systematic correlation of cardiac chamber size and ventricular performance determined with echocardiography and alterations in heart rate in normal persons. The American journal of cardiology, 43(1), 1–9. https://doi.org/10.1016/0002-9149(79)90036-5.
• Di Donato, M., Mori, F., Barletta, G., Dabizzi, R. P., & Fantini, F. (1982). Effect of dextran infusion on left atrial size in normal subjects. Cardiology, 69(5), 257–264. https://doi.org/10.1159/000173514
• Dircks, B. H., Mischke, R., & Schuberth, H. J. (2012). Platelet-neutrophil aggregate formation in blood samples from dogs with systemic inflammatory disorders. American journal of veterinary research, 73(7), 939–945. https://doi.org/10.2460/ajvr.73.7.939
• Drobin, D., & Hahn, R. G. (2002). Kinetics of isotonic and hypertonic plasma volume expanders. Anesthesiology, 96(6), 1371–1380. https://doi.org/10.1097/00000542-200206000-00016
• Duvekot, J.J., Cheriex, E.C., Tan, W.D., Heidendal, G. A. K., Peeters, L. L. H. (1994). Volume-dependent echocardiographic parameters are not useful for estimating baseline blood volume but are useful for detecting acute changes in vascular filling state. Basic Res Cardiol 89, 270–277. https://doi.org/10.1007/BF00795619
• Fink M. P. (2001). Cytopathic hypoxia. Mitochondrial dysfunction as mechanism contributing to organ dysfunction in sepsis. Critical care clinics, 17(1), 219–237. https://doi.org/10.1016/s0749-0704(05)70161-5
• Fox, P. R., Liu, S. K., & Maron, B. J. (1995). Echocardiographic assessment of spontaneously occurring feline hypertrophic cardiomyopathy. An animal model of human disease. Circulation, 92(9), 2645–2651. https://doi.org/10.1161/01.cir.92.9.2645
• Goertz, A. W., Mehl, T., Lindner, K. H., Rockemann, M. G., Schirmer, U., Schwilk, B., & Georgieff, M. (1995). Effect of 7.2% hypertonic saline/6% hetastarch on left ventricular contractility in anesthetized humans. Anesthesiology, 82(6), 1389–1395. https://doi.org/10.1097/00000542-199506000-00010
• Gommeren, K., Desmas, I., Garcia, A., Clercx, C., Mc Entee, K., & Peeters, D. (2012). Cardiac ultrasound in canine emergencies with a systemic inflammatory response syndrome. In 2nd Edition, Scientific Day.
• Hamacher, L., Dörfelt, R., Müller, M., & Wess, G. (2015). Serum cardiac troponin I concentrations in dogs with systemic inflammatory response syndrome. Journal of veterinary internal medicine, 29(1), 164–170. https://doi.org/10.1111/jvim.12474
• Hinshaw L. B. (1996). Sepsis/septic shock: participation of the microcirculation: an abbreviated review. Critical care medicine, 24(6), 1072–1078. https://doi.org/10.1097/00003246-199606000-00031
• Kien, N. D., & Kramer, G. C. (1989). Cardiac performance following hypertonic saline. Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas, 22(2), 245–248.
• Kien, N. D., Reitan, J. A., White, D. A., Wu, C. H., & Eisele, J. H. (1991). Cardiac contractility and blood flow distribution following resuscitation with 7.5% hypertonic saline in anesthetized dogs. Circulatory shock, 35(2), 109–116.
• Lopes, O. U., Pontieri, V., Rocha e Silva, M., Jr, & Velasco, I. T. (1981). Hyperosmotic NaCl and severe hemorrhagic shock: role of the innervated lung. The American journal of physiology, 241(6), H883–H890. https://doi.org/10.1152/ajpheart.1981.241.6.H883
• McLean, AS. (2016). Echocardiography in shock management. Critical Care, 20(1), 275. https://doi.org/10.1186/s13054-016-1401-7
• Mouren, S., Delayance, S., Mion, G., Souktani, R., Fellahi, J. L., Arthaud, M., Baron, J. F., & Viars, P. (1995). Mechanisms of increased myocardial contractility with hypertonic saline solutions in isolated blood-perfused rabbit hearts. Anesthesia and analgesia, 81(4), 777–782. https://doi.org/10.1097/00000539-199510000-00021
• Muir, W. W., 3rd, & Sally, J. (1989). Small-volume resuscitation with hypertonic saline solution in hypovolemic cats. American journal of veterinary research, 50(11), 1883–1888.
• Nelson, O. L., & Thompson, P. A. (2006). Cardiovascular dysfunction in dogs associated with critical illnesses. Journal of the American Animal Hospital Association, 42(5), 344–349. https://doi.org/10.5326/0420344
• Ogino, R., Suzuki, K., Kohno, M., Nishina, M., & Kohama, A. (1998). Effects of hypertonic saline and dextran 70 on cardiac contractility after hemorrhagic shock. The Journal of trauma, 44(1), 59–69. https://doi.org/10.1097/00005373-199801000-00005
• Okano, S., Yoshida, M., Fukushima, U., Higuchi, S., Takase, K., & Hagio, M. (2002). Usefulness of systemic inflammatory response syndrome criteria as an index for prognosis judgement. The Veterinary record, 150(8), 245–246. https://doi.org/10.1136/vr.150.8.245
• Rau, S., Kohn, B., Richter, C., Fenske, N., Küchenhoff, H., Hartmann, K., Härtle, S., Kaspers, B., & Hirschberger, J. (2007). Plasma interleukin-6 response is predictive for severity and mortality in canine systemic inflammatory response syndrome and sepsis. Veterinary clinical pathology, 36(3), 253–260. https://doi.org/10.1111/j.1939-165x.2007.tb00220.x
• Rush, J. E., Freeman, L. M., Fenollosa, N. K., & Brown, D. J. (2002). Population and survival characteristics of cats with hypertrophic cardiomyopathy: 260 cases (1990-1999). Journal of the American Veterinary Medical Association, 220(2), 202–207. https://doi.org/10.2460/javma.2002.220.202
• Shapiro, N. I., Schuetz, P., Yano, K., Sorasaki, M., Parikh, S. M., Jones, A. E., Trzeciak, S., Ngo, L., & Aird, W. C. (2010). The association of endothelial cell signaling, severity of illness, and organ dysfunction in sepsis. Critical care (London, England), 14(5), R182. https://doi.org/10.1186/cc9290
• Sirieix, D., Hongnat, J. M., Delayance, S., D'Attellis, N., Vicaut, E., Bérrébi, A., Paris, M., Fabiani, J. N., Carpentier, A., & Baron, J. F. (1999). Comparison of the acute hemodynamic effects of hypertonic or colloid infusions immediately after mitral valve repair. Critical care medicine, 27(10), 2159–2165. https://doi.org/10.1097/00003246-199910000-00014
• Suzuki, K., Aoyagi, S., Koie, H., & Asano, R. (2006). The effect of 7.2% hypertonic saline solution on m-mode echocardiographic indices in normovolemic dogs. The Journal of veterinary medical science, 68(7), 749–751. https://doi.org/10.1292/jvms.68.749
• Suzuki, K., Otake, M., Saida, Y., Koie, H., & Asano, R. (2008). The effect of 7.2% hypertonic saline solution with 6% dextran 70 on cardiac contractility as observed by an echocardiography in normovolemic and anesthetized dogs. The Journal of veterinary medical science, 70(1), 89–94. https://doi.org/10.1292/jvms.70.89
• Suzuki, K., Suzuki, T., Miyahara, M., Iwabuchi, S., & Asano, R. (2005). Comparison of a small volume of hypertonic saline solution and dextran 40 on hemodynamic alternations in conscious calves. Journal of veterinary science, 6(2), 111–116.
• Tavanaeimanesh, H., Dezfouli, M. R., Vajhi, A., Rostam, A., Akbarinejad, V., Sadeghian Chaleshtori, S., & Corley, K. T. (2015). The effect of 7.2% hypertonic saline solution on echocardiographic parameters of healthy horses. Equine veterinary journal, 47(6), 741–744. https://doi.org/10.1111/evj.12496
• Torrente, C., Manzanilla, E. G., Bosch, L., Fresno, L., Rivera Del Alamo, M., Andaluz, A., Saco, Y., & Ruiz de Gopegui, R. (2015). Plasma iron, C-reactive protein, albumin, and plasma fibrinogen concentrations in dogs with systemic inflammatory response syndrome. Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001), 25(5), 611–619. https://doi.org/10.1111/vec.12340
• Us, M. H., Ozkan, S., Oral, L., Oğuş, T., Acar, H. V., Cakir, O., Keskin, O., Top, C., & Gökben, M. (2001). Comparison of the effects of hypertonic saline and crystalloid infusions on haemodynamic parameters during haemorrhagic shock in dogs. The Journal of international medical research, 29(6), 508–515. https://doi.org/10.1177/147323000102900607
• Velasco, I. T., & Baena, R. C. (2004). The role of the vagus nerve in hypertonic resuscitation of hemorrhagic shocked dogs. Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas, 37(3), 419–425. https://doi.org/10.1590/s0100-879x2004000300020 Velasco, I. T., Pontieri, V., Rocha e Silva, M., Jr, & Lopes, O. U. (1980). Hyperosmotic NaCl and severe hemorrhagic shock. The American journal of physiology, 239(5), H664–H673. https://doi.org/10.1152/ajpheart.1980.239.5.H664
• Waagstein, L. M., Wennberg, E., Waagstein, F., & Haljamäe, H. (1999). Hypertonic saline without or with dextran-70 in the treatment of experimental acute myocardial ischemia and reperfusion. Critical care medicine, 27(3), 605–616. https://doi.org/10.1097/00003246-199903000-00043
• Wildenthal, K., Adcock, R. C., Crie, J. S., Templeton, G. H., & Willerson, J. T. (1975). Negative inotropic influence of hyperosmotic solutions on cardiac muscle. The American journal of physiology, 229(6), 1505–1509. https://doi.org/10.1152/ajplegacy.1975.229.6.