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Background: Surgical blood loss can lead to ineffective tissue perfusion of vital organs, including the kidney. Physiologic solution chosen for blood volume replacement may be determinant for preserving renal integrity.
Objectives: Study kidney histopathological changes in a hemorrhagic model, followed by intravascular volume replacement with Ringer's lactate or Hydroxyethylstarch 130/0.4 solutions.
Methods: Thirty one pigs under general anaesthesia with propofol and remifentanil underwent haemorrhage at a volume of 25ml kg-1, over 20 minutes. After a waiting period, intravascular volume was replaced using HES 130/0.4 (group 1) and Ringer’s lactate (group 2). One hour after, pigs were euthanized and sixty two renal samples were taken for histopathological examination, using PAS staining. Renal damage was assessed for glomerular, tubulointerstitial and vascular lesions. Contingency tables for frequency analysis were used.
Results: Mean arterial pressure values (MAP) reached 40 mmHg after bleeding, and recovered for values above 60 mmHg in both groups after volume replacement. Histopathological lesions observed in Group 2 were more frequent than those in Group 1.
Conclusion: HES 130/0.4 may reduce the incidence of histopathological lesions secondary to renal hypoperfusion after severe bleeding when compared with Ringer Lactate. Results suggest that reestablishment of intravascular volume with HES 130/0.4 may preserve renal integrity secondary to blood loss.
Descrição
Palavras-chave
Surgical blood loss tissue perfusion blood volume replacement kidney histopathological changes in a hemorrhagic model Physiologic solution chosen for blood volume replacement Ringer's lactate Hydroxyethylstarch 130/0.4
Contexto Educativo
Citação
Cruz R, Vala H, Venâncio C, Mesquita J, Mega AC, Silva A, Ortiz AL, Ferreira D. (2012). Histopathological assessment of renal lesions after volume replacement with HES 130/0.4 or Ringer solution, following acute bleeding. Virchows Archiv. 461(Suppl 1): S268