Effect of controlled hypotensive hemorrhage on plasma sodium levels in anesthetized pigs : An exploratory study
(2023) In Physiological Reports 11(22).- Abstract
Perioperative hyponatremia, due to non-osmotic release of the antidiuretic hormone arginine vasopressin, is a serious electrolyte disorder observed in connection with many types of surgery. Since blood loss during surgery contributes to the pathogenesis of hyponatremia, we explored the effect of bleeding on plasma sodium using a controlled hypotensive hemorrhage pig model. After 30-min baseline period, hemorrhage was induced by aspiration of blood during 30 min at mean arterial pressure <50 mmHg. Thereafter, the animals were resuscitated with retransfused blood and a near-isotonic balanced crystalloid solution and monitored for 180 min. Electrolyte and water balances, cardiovascular response, renal hemodynamics, and markers of volume... (More)
Perioperative hyponatremia, due to non-osmotic release of the antidiuretic hormone arginine vasopressin, is a serious electrolyte disorder observed in connection with many types of surgery. Since blood loss during surgery contributes to the pathogenesis of hyponatremia, we explored the effect of bleeding on plasma sodium using a controlled hypotensive hemorrhage pig model. After 30-min baseline period, hemorrhage was induced by aspiration of blood during 30 min at mean arterial pressure <50 mmHg. Thereafter, the animals were resuscitated with retransfused blood and a near-isotonic balanced crystalloid solution and monitored for 180 min. Electrolyte and water balances, cardiovascular response, renal hemodynamics, and markers of volume regulation and osmoregulation were investigated. All pigs (n = 10) developed hyponatremia. All animals retained hypotonic fluid, and none could excrete net-free water. Urinary excretion of aquaporin 2, a surrogate marker of collecting duct responsiveness to antidiuretic hormone, was significantly reduced at the end of the study, whereas lysine vasopressin, i.e., the pig antidiuretic hormone remained high. In this animal model, hyponatremia developed due to net positive fluid balance and generation of electrolyte-free water by the kidneys. A decreased urinary aquaporin 2 excretion may indicate an escape from antidiuresis.
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- author
- Krmar, Rafael T. ; Franzén, Stephanie ; Karlsson, Leif ; Strandberg, Helin LU ; Törnroth-Horsefield, Susanna LU ; Andresen, Jesper K. ; Jensen, Boye L. ; Carlström, Mattias and Frithiof, Robert
- organization
- publishing date
- 2023-11
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- aquaporin 2, hemorrhage, hyponatremia, pig model, renin-angiotensin aldosterone, vasopressin-neurophysin 2-copeptin
- in
- Physiological Reports
- volume
- 11
- issue
- 22
- article number
- e15886
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- pmid:38010195
- scopus:85177818957
- ISSN
- 2051-817X
- DOI
- 10.14814/phy2.15886
- language
- English
- LU publication?
- yes
- additional info
- Funding Information: This work was funded by the Swedish Research Council (2020‐01645 to M.C. and 2014‐02569 and 2014‐07606 to R.F.), the Swedish Heart and Lung Foundation (20210431 to M.C.), NovoNordisk (2019#0055026 to M.C.), and by Research Funding from the Karolinska Institutet, Stockholm, Sweden. Publisher Copyright: © 2023 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.
- id
- d2435752-62e8-47f4-9601-d78895f76368
- date added to LUP
- 2024-01-04 11:58:51
- date last changed
- 2024-04-19 08:14:59
@article{d2435752-62e8-47f4-9601-d78895f76368,
abstract = {{<p>Perioperative hyponatremia, due to non-osmotic release of the antidiuretic hormone arginine vasopressin, is a serious electrolyte disorder observed in connection with many types of surgery. Since blood loss during surgery contributes to the pathogenesis of hyponatremia, we explored the effect of bleeding on plasma sodium using a controlled hypotensive hemorrhage pig model. After 30-min baseline period, hemorrhage was induced by aspiration of blood during 30 min at mean arterial pressure <50 mmHg. Thereafter, the animals were resuscitated with retransfused blood and a near-isotonic balanced crystalloid solution and monitored for 180 min. Electrolyte and water balances, cardiovascular response, renal hemodynamics, and markers of volume regulation and osmoregulation were investigated. All pigs (n = 10) developed hyponatremia. All animals retained hypotonic fluid, and none could excrete net-free water. Urinary excretion of aquaporin 2, a surrogate marker of collecting duct responsiveness to antidiuretic hormone, was significantly reduced at the end of the study, whereas lysine vasopressin, i.e., the pig antidiuretic hormone remained high. In this animal model, hyponatremia developed due to net positive fluid balance and generation of electrolyte-free water by the kidneys. A decreased urinary aquaporin 2 excretion may indicate an escape from antidiuresis.</p>}},
author = {{Krmar, Rafael T. and Franzén, Stephanie and Karlsson, Leif and Strandberg, Helin and Törnroth-Horsefield, Susanna and Andresen, Jesper K. and Jensen, Boye L. and Carlström, Mattias and Frithiof, Robert}},
issn = {{2051-817X}},
keywords = {{aquaporin 2; hemorrhage; hyponatremia; pig model; renin-angiotensin aldosterone; vasopressin-neurophysin 2-copeptin}},
language = {{eng}},
number = {{22}},
publisher = {{John Wiley & Sons Inc.}},
series = {{Physiological Reports}},
title = {{Effect of controlled hypotensive hemorrhage on plasma sodium levels in anesthetized pigs : An exploratory study}},
url = {{http://dx.doi.org/10.14814/phy2.15886}},
doi = {{10.14814/phy2.15886}},
volume = {{11}},
year = {{2023}},
}