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Renal haemodynamic response to amino acids infusion in an experimental porcine model of septic shock
Author(s) -
VASSAL O.,
BONNET J.M.,
BARTHELEMY A.,
ALLAOUCHICHE B.,
GOYTHOLLOT I.,
LOUZIER V.,
PAQUET C.,
AYOUB J.Y.,
DAUWALDER O.,
JACQUETLAGRÈZE M.,
JUNOT S.
Publication year - 2015
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12507
Subject(s) - medicine , renal blood flow , septic shock , renal function , sepsis , mean arterial pressure , vascular resistance , acute kidney injury , hemodynamics , shock (circulatory) , perfusion , kidney , pulmonary artery catheter , anesthesia , blood pressure , cardiac output , urology , heart rate
Background Acute kidney injury ( AKI ) is common in sepsis. Treatments allowing maintenance of renal blood flow ( RBF ) could help to prevent AKI associated with renal hypoperfusion. Amino acids ( AA ) have been associated with an increase of RBF and glomerular filtration rate ( GFR ) in several species. The aim of this study was to evaluate the effects of an AA infusion on RBF and GFR in a porcine model of septic shock. Methods A total of 17 piglets were randomly assigned into three groups: S ham ( S ham, n = 5), sepsis without AA ( S ‐ NAA , n = 6), sepsis treated with AA ( S ‐ AA , n = 6). Piglets preparation included the placement of ultrasonic transit time flow probes around left renal artery for continuous RBF measurement; ureteral catheters for GFR and urine output evaluation; pulmonary artery catheter for cardiac output ( CO ) and pulmonary arterial pressure measurements. Mean arterial pressure ( MAP ) and renal vascular resistance ( RVR ) were also determined. Septic shock was induced with a live P seudomonas aeruginosa infusion. Crystalloids, colloids and epinephrine infusion were used to maintain and restore MAP > 60 mmHg and CO > 80% from baseline. Results Renal haemodynamic did not change significantly in the S ham group, whereas RBF increased slightly in the S ‐ NAA group. Conversely, a significant increase in RVR and a decrease in RBF and GFR were observed in the S ‐ AA group. AA infusion was associated with a higher requirement of epinephrine [340.0 (141.2; 542.5) mg vs. 32.5 (3.8; 65.0) mg in the S ‐ NAA group P = 0.044]. Conclusion An infusion of amino acids impaired renal haemodynamics in this experimental model of septic shock.