Intensive Care Medicine

, Volume 36, Issue 3, pp 541–548

The impact of crystalloid and colloid infusion on the kidney in rodent sepsis

Authors

  • Martin Alexander Schick
    • Klinik und Poliklinik für Anästhesiologie, Zentrum für Operative MedizinUniversity of Würzburg
  • Tobias Jobst Isbary
    • Klinik und Poliklinik für Anästhesiologie, Zentrum für Operative MedizinUniversity of Würzburg
  • Nicolas Schlegel
    • Institute of Anatomy and Cell BiologyUniversity of Würzburg
    • Department of Surgery I, Zentrum für Operative MedizinUniversity of Würzburg
  • Juergen Brugger
    • Klinik und Poliklinik für Anästhesiologie, Zentrum für Operative MedizinUniversity of Würzburg
  • Jens Waschke
    • Institute of Anatomy and Cell BiologyUniversity of Würzburg
  • Ralf Muellenbach
    • Klinik und Poliklinik für Anästhesiologie, Zentrum für Operative MedizinUniversity of Würzburg
  • Norbert Roewer
    • Klinik und Poliklinik für Anästhesiologie, Zentrum für Operative MedizinUniversity of Würzburg
    • Klinik und Poliklinik für Anästhesiologie, Zentrum für Operative MedizinUniversity of Würzburg
Experimental

DOI: 10.1007/s00134-009-1704-0

Cite this article as:
Schick, M.A., Isbary, T.J., Schlegel, N. et al. Intensive Care Med (2010) 36: 541. doi:10.1007/s00134-009-1704-0

Abstract

Purpose

Volume replacement remains one of the pillars of sepsis therapy. The effect of different volume solutions on kidney function in sepsis still remains unclear. We therefore determined the impact of crystalloid and colloid solutions on kidney function in a rodent model of abdominal sepsis induced by cecal ligation and puncture (CLP).

Methods

Anesthetized rats underwent the CLP procedure, whereas control animals were sham operated. Septic animals were treated with crystalloid and colloid solutions. Hemodynamic variables and blood gases were measured. After 24 h animals were re-anesthetized, the kidneys were harvested, and creatinine (crea), urea, cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) were investigated.

Results

Septic animals exhibited a mortality rate of 19% after 24 h. Gelatin-treated animals showed significantly increased levels of crea and urea. Colloids [gelatin 4% (Gel) or hydroxyethyl starch 6% 130/0.4 (HES)] as volume replacement resulted in elevated levels of NGAL. The histopathological observations revealed that Gel- and HES-treated animals showed vesicles within epithelial cells of the tubulus system and an overall increased injury. In contrast, total injury scores in groups treated with crystalloids [0.9% NaCl (NaCl) and Sterofundin® ISO (SteroIso)] were not significantly different compared to sham-treated animals.

Conclusion

None of the examined volume solution was inert to the kidney. In a CLP rodent sepsis model, animals infused with balanced crystalloid SteroIso exhibited the least effects on kidney function. Both hydroxyethyl starch 6% 130/0.4 and gelatin 4% derogated the kidney, whereas gelatin was more harmful when compared with hydroxyethyl starch.

Keywords

Sepsis Gelatin Hydroxyethyl starch Renal failure Volume therapy

Copyright information

© Copyright jointly hold by Springer and ESICM 2009