Avaliação comparativa entre diferentes modalidades de reposição hidroeletrolítica em equinos desidratados experimentalmente pela utilização de parâmetros do exame físico e marcadores hematológicos / Comparative evaluation between different kinds of hydroeletrolitic reposition in horses experimentally dehydrated by the use of physical examination parameters and hematological markers

O objetivo do presente estudo foi realizar a comparação entre três modalidades de terapias hidroeletrolíticas, sendo uma hipotônica (SeHIPO) e outra isotônica (SeISO), ambas por via enteral em fluxo contínuo (HETfc), com a solução de ringer lactato por via intravenosa (RL IV), na taxa de infusão de 15 ml/kg/h, administradas simultaneamente em tempo real por 8 horas num delineamento crossover6X3 em equinos desidratados experimentalmente pela utilização de parâmetros clínicos do exame físico e de alguns exames laboratoriais. Para tanto foram utilizadas 6 éguas adultas da raça Brasileiro de Hipismo submetidas a um protocolo experimental de indução de desidratação (PD) e posteriormente tratadas de acordo com o delineamento experimental. Os resultados obtidos demonstraram que ambos os tratamentos HETfc demonstraram eficácia equivalente ao RL IV na reversão dos efeitos determinados pelo PD, ainda que para os marcadores da volemia, tais como o Volume Globular (VG), Proteínas Plasmáticas Totais (PPT) e porcentagem de Volume Plasmático (%VP) tenham sido relativamente mais lentos. Porém, para os demais marcadores clínicos a eficácia entre as três terapias estudadas foi equivalente. Esses resultados comprovam a ação das terapias HETfc ao serem comparadas ao tratamento RL IV, pela utilização dos marcadores clínicos e laboratoriais utilizados, e justificam a indicação e utilização dessas modalidades terapêuticas em equinos.

The objective of the present study was to compare three modalities of hydroelectrolytic therapies, one hypotonic (SeHIPO) and another isotonic (SeISO), both by continuous enteral flow (HETfc), with intravenous lactated ringer solution ( RL IV), at the infusion rate of 15 ml / kg / h, administered simultaneously in real time for 8 hours in a 6X3 crossover design in horses experimentally dehydrated by the use of clinical parameters of the physical examination and some laboratory tests. Six adult mares of the Brazilian Equestrian race were submitted to an experimental protocol for induction of dehydration (PD) and later treated according to the experimental design. The results showed that both HETfc treatments demonstrated an efficacy equivalent to RL IV in the reversal of the effects determined by PD, although for volume markers such as Globular Volume (VG), Total Plasma Proteins (PPT) and Percentage of Plasmatic Volume (% VP) were relatively slower. However, for the other clinical markers the efficacy among the three therapies studied was equivalent. These results confirm the action of HETfc therapies when compared to RL IV treatment, by the clinical and laboratorial markes used, and justify the indication and use of these therapeutic modalities in horses.

Recovery of cell volume and electrolytes of A6 cells after re-establishing isotonicity following hypotonic stress.

Cellular element concentrations and dry weight contents in A6 cells were determined using electron microprobe analysis to establish whether these cells exhibit a regulatory volume increase (post-RVD-RVI) when re-establishing isotonicity following a hypotonically induced regulatory volume decrease (RVD). Hypotonic stress was induced by reducing basolateral [NaCl], and hence, osmolarity fell from 260 to 140 mosmol/l. The alterations in cell volume after re-establishing isotonicity, calculated from the cellular dry weight changes, indicate within the first 2 min cell shrinkage from 120 to 76% of control, compatible with almost ideal osmometric behaviour of A6 cells, and thereafter a post-RVD-RVI to 94%. The cellular uptake of osmolytes necessary to explain the post-RVD-RVI could be accounted for solely by a gain in cellular K and Cl. The involvement of a Na-K-2Cl cotransporter in most of the KCl uptake seems plausible since basolateral bumetanide blocked KCl uptake and post-RVD-RVI. The net uptake of cations (K uptake of 185.2, Na loss of 8.2 mmol/kg dry wt) during the isotonic period exceeded the Cl uptake by 38.2 mmol/kg dry wt, suggesting the uptake of another anion and/or the alteration of cellular buffer capacity. The relatively low Na concentration maintained during the isotonic period (13.3 vs. 20.4 mmol/kg wet wt under control conditions) might favour electrolyte uptake via the Na-K-2Cl cotransporter.

Transurethral resection syndrome: effect of the introduction into clinical practice of a new method for monitoring fluid absorption.

STUDY OBJECTIVE: To determine the effects of introduction of a new monitoring system for fluid absorption during transurethral resection of the prostate (TURP) using an irrigating solution containing 0.5% alcohol. STUDY DESIGN: Prospective clinical investigation, with implementation of statistical process control. SETTING: Inpatients for TURP at a major non-university teaching hospital. PATIENTS: 312 male ASA physical status I, II, III, and IV patients scheduled for TURP. INTERVENTIONS: Intraoperative breath alcohol levels were measured for detection of fluid absorption. MEASUREMENTS AND MAIN RESULTS: Calculation of the amount of fluid absorbed using measured breath alcohol values. Process variability (i.e., numbers of patients with significant fluid absorption) was defined by statistical process control tools. No trend change of prevalence of fluid absorption was noted until 150 procedures had been completed. Reduction of prevalence of significant fluid absorption was noted and no patients were treated postoperatively in the intensive care unit. No relevant side effects were seen in patients with significant fluid absorption. No mortality and no severe clinical morbidity was seen after the introduction of the new monitoring. CONCLUSION: Using an irrigating fluid marked with 0.5% ethanol resulted in a decreased prevalence of fluid absorption over time.

Efficacy of a standard United Kingdom oral rehydration solution (ORS) and a hypotonic ORS assessed by human intestinal perfusion.

Human triple-lumen intestinal perfusion was used to compare water and solute absorption from the oral rehydration solution (ORS) most widely used in the United Kingdom and a new experimental hypotonic ORS (HYPO-ORS). HYPO-ORS (osmolality 210 mOsm/kg) promoted significantly greater water absorption than UK-ORS (7.03 +/- 1.1 vs 2.73 +/- 1.0 ml cm-1 h-1; P less than 0.01). HYPO-ORS produced net sodium and chloride absorption whereas the low sodium UK-ORS produced a net secretion of these ions. Bicarbonate absorption was also greater from HYPO-ORS although potassium and glucose absorption were similar from both solutions. This study suggests that UK-ORS may not promote optimal water and solute absorption and that clinical studies with HYPO-ORS are indicated.