Effect of hypertonic and isotonic saline solutions on plasma constituents of conscious horses.

Blood constituents and vascular volume indices were determined in 5 standing horses by use of 2-period crossover experimental design. Horses were either administered hypertonic (2,400 mosm/kg of body weight, i.v.) or isotonic (300 mosm/kg, i.v.) saline solution. Each solution was administered at a dosage of 5 ml/kg (infusion rate, 80 ml/min). Samples for determination of PCV, plasma volume, blood volume, plasma osmolality, total amount of plasma protein and plasma concentrations of protein, Na, K, and Cl were collected at 0 hour (baseline, before fluid infusion) and 0.5 hour (at the end of fluid infusion), and subsequently, at 0.25- or 0.5-hour intervals for 4.5 hours. All horses were given the predetermined dose of fluids by 0.5 hour after beginning the saline infusion. Values of P < or = 0.05 were considered significant. Administration of hypertonic saline solution was associated with decreased mean body weight by 4.5 hours, but weight change after isotonic saline administration was not significant. Other than body weight and plasma protein concentration, between-trial difference (treatment effect) was not observed for any measured variable or index. The F values indicated that increasing the number of horses would have not changed these results. A time effect was evident across both trials, so that mean (+/- SD) plasma volume increased (12.3 +/- 1.07%) and mean plasma protein concentration (-12.1 +/- 1.03%) and PCV (-11.9 + 0.67%) decreased proportionately and transiently in association with administration of either fluid at that volume. Other time effects included increased plasma osmolality and Na and Cl concentrations. Blood volume estimates and total amount of plasma protein remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)     

Cardiovascular and pulmonary effects of hetastarch plus hypertonic saline solutions during experimental endotoxemia in anesthetized horses

BACKGROUND: Small volume resuscitation has been advocated as a beneficial therapy for endotoxemia in horses but this therapy has not been investigated in a prospective manner. The objective of this study was to determine the cardiopulmonary effects of small-volume resuscitation using hypertonic saline solution (HSS) plus Hetastarch (HES) during experimental endotoxemia in anesthetized horses. HYPOTHESIS: Treatment of horses with induced endotoxemia using HES-HSS does not alter the response of various cardiopulmonary indices when compared to treatment with either small- or large-volume isotonic crystalloid solutions. ANIMALS: Eighteen healthy horses were randomly assigned to 1 of 3 groups. Anesthesia was maintained with halothane. Endotoxemia was induced by administering 50 microg/kg of Escherichia coli endotoxin IV. The horses were treated over 30 minutes with 15 mL/kg of balanced polyionic crystalloid solution (control), 60 mL/kg of balanced polyionic crystalloid solution (ISO), or 5 mL/kg of HSS followed by 10 mL/kg of HES (HSS-HES). METHODS: Prospective randomized trial. RESULTS: Cardiac output (CO) after endotoxin infusion increased significantly (P < .05) from baseline in all groups, whereas mean central venous pressure increased significantly (P < .05) in the ISO group only. Mean pulmonary artery pressure increased from baseline (P < .05) in horses treated with isotonic fluids and HSS-HES. There was no effect of treatment with HSS-HES on CO, systemic vascular resistance (SVR), mean arterial pressure, blood lactate concentrations, or arterial oxygenation. CONCLUSIONS AND CLINICAL IMPORTANCE: The use of HSS-HES failed to ameliorate the deleterious hemodynamic responses associated with endotoxemia in horses. The clinical value of this treatment in horses with endotoxemia remains unconfirmed.     

Respiratory and metabolic effects of massive administration of isotonic saline solution in heaves-affected and control horses

REASONS FOR PERFORMING STUDY: It has been suggested that rapid administration of isotonic saline solution relieves airway obstruction in heaves-affected horses, but the efficacy and tolerability of this treatment is poorly documented. OBJECTIVES: To determine the respiratory and metabolic effects of a rapid administration of isotonic saline solution in control horses and those with heaves. METHODS: Thirty litres isotonic saline solution were administered i.v. to 5 control (Group C) and 9 heaves-affected horses (Group H). Pulmonary function testing and arterial blood gas analysis were performed prior to saline infusion, at 90 and 180 mins after starting the infusion, and 1, 3, 6 and 10 days later. PCV, plasma total solids, plasma electrolytes (Na+, Cl- and K+) and venous blood gas analysis were performed prior, during and after saline infusion. RESULTS: Rapid saline administration was shown to have no beneficial effects on lung function during infusion in Group H. On the contrary, they had significantly increased pulmonary resistance (RL) at 180 mins following the initiation of saline administration compared to baseline. In Group C, saline administration resulted in a significant increase in RL at 180 mins and a significant decrease in PaO2 at 90 mins. These results suggest a transient decrement in lung function caused by rapid saline administration. Group H had a metabolic alkalosis with hypochloraemia at baseline compared to control horses. This resolved following i.v. saline administration and returned to baseline within 6 h after treatment had been discontinued. CONCLUSION: The administration of saline to Group H did not improve airway function significantly, but resulted in mild and transient side effects. POTENTIAL RELEVANCE: Rapid administration of isotonic saline alone is not an effective therapy for heaves in horses.     

Preoperative administration of hydroxyethyl starch or hypertonic saline to horses with colic

BACKGROUND: Hypertonic saline and hydroxyethyl starches have been proposed as alternatives to isotonic crystalloids for reversal of hypovolemia in horses with colic. However, no direct comparison of these fluids has been performed in a clinical setting. HYPOTHESIS: Preoperative administration of hypertonic saline or pentastarch would produce similar effects on intra operative hemodynamics in horses with colic. ANIMALS: Thirty horses requiring colic surgery were enrolled in this prospective, randomized, open-label clinical trial. Inclusion criteria were owner consent, and at least 2 of 3 clinicopathologic abnormalities: packed cell volume >45%, plasma total solid concentration >8.0 g/dL, and blood lactate concentration >2.5 mM. METHODS: Study horses were randomly assigned to receive 4 mL/kg hypertonic saline or pentastarch before induction of anesthesia. Hemodynamic measurements were recorded every 30 minutes during anesthesia. Cardiac output (CO) was measured by the lithium dilution method. CO and stroke volume (SV) were indexed by body weight. Data were analysed using repeated measures analysis of variance (ANOVA). Post hoc comparisons were performed using the Bonferroni test. RESULTS: Cardiac index (CI) was higher in the pentastarch group compared with the hypertonic saline group from 30 to 150 minutes after induction (P = .04). SV index was higher in the pentastarch group at 30 (P = .025) and 60 minutes (P = .04). Mean arterial pressure of horses in both groups was lower at 90 minutes compared with 30 and 60 minutes. CONCLUSIONS AND CLINICAL IMPORTANCE: Preoperative administration of pentastarch results in better CI than hypertonic saline, for 150 minutes after anesthetic induction. The effect of this improved global blood flow on regional perfusion or clinical outcome remains to be elucidated.     

Influence of preinduction methoxamine, lactated Ringer solution, or hypertonic saline solution infusion or postinduction dobutamine infusion on anesthetic-induced hypotension in horses

A controlled study of the cardiovascular responses in horses anesthetized with acepromazine (0.05 mg/kg of body weight, IV), guaifenesin (100 mg/kg, IV), thiamylal (5.0 mg/kg, IV), and halothane in O2 (1.2 to 1.4% end-expired concentration) was performed to determine whether hypotension could be prevented by use of various treatments. Six horses were given 5 treatments in a randomized sequence: no treatment (control), methoxamine (0.04 mg/kg, IV), lactated Ringer solution (20.0 ml/kg, IV), 7.5% hypertonic saline solution (4.0 ml/kg, IV), or constant infusion of dobutamine (5.0 mg/kg/min, IV) during anesthesia. Heart rate, ECG, blood pressure, central venous pressure, cardiac output, blood gas analysis, PVC, and plasma total protein concentration were measured during the study. Compared with the control value, an increase in blood pressure during halothane administration was observed after administration of lactated Ringer solution, hypertonic saline solution, or dobutamine (P less than 0.05). The improved blood pressure response to hypertonic saline solution and dobutamine was related to an increase in cardiac output, which was statistically significant (P less than 0.05). Other statistically significant differences in cardiopulmonary responses among treatments were not observed during anesthesia. The PCV was increased in response to dobutamine infusion, and plasma total protein concentration was reduced in response to administration of hypertonic saline or lactated Ringer solution.     

Small-volume resuscitation with hypertonic saline solution in hypovolemic cats

We evaluated the hemodynamic effects of IV and intraaortic (aortic root) administration of 7.5% NaCl solution on hemodynamics in anesthetized cats with severe hypovolemia. Hypovolemic shock was induced by exsanguinating cats to a mean arterial blood pressure of 50 mm of Hg, which was maintained for 30 minutes prior to treatment. Shed blood volume was 38.4 +/- 2.1 ml/kg of body weight. The cats were treated with a small volume (4 ml/kg) of 0.9% NaCl solution IV, 7.5% NaCl solution IV, or 7.5% NaCl solution administered into the aortic root. The IV administration of 0.9% NaCl solution did not improve hemodynamics. The IV administration of 7.5% NaCl solution induced rapid restoration of arterial blood pressure, aortic blood flow, and cardiac contractility. Total peripheral vascular resistance decreased. The administration of 7.5% NaCl solution into the aortic root induced a further deterioration in hemodynamics resulting in death in 3 cats and a marked improvement in hemodynamics similar to that observed after IV administration of 7.5% NaCl solution in 2 cats. The duration of the beneficial hemodynamic effects after IV or intra-aortic administration of 7.5% NaCl solution did not exceed 60 minutes. Results of these studies suggested that either the IV or intra-aortic administration of 7.5% NaCl solution in cats can induce beneficial hemodynamic effects that may be of value in the field resuscitation of hypovolemic patients.     

Hemodynamic response of endotoxemic calves to treatment with small-volume hypertonic saline solution

The hemodynamic effects of hypertonic saline solution (HSS) resuscitation on endotoxic shock were examined in pentobarbital-anesthetized calves (8 to 20 days old). Escherichia coli (055:B5) endotoxin was infused IV at dosage of 0.1 microgram/kg of body weight for 30 minutes. Endotoxin induced large decreases in cardiac index, stroke volume, maximal rate of change of left ventricular pressure (+dP/dtmax), femoral and mesenteric arterial blood flow, glomerular filtration rate, urine production, and mean aortic pressure. Severe pulmonary arterial hypertension and increased pulmonary vascular resistance were evident at the end of endotoxin infusion. Treatment with HSS (2,400 mosm of NaCl/L, 4 ml/kg) or an equivalent sodium load of isotonic saline solution (ISS: 300 mosm of NaCl/L, 32 ml/kg) was administered 90 minutes after the end of endotoxin administration. Both solutions were infused IV over a 4- to 6-minute period. Administration of HSS induced immediate and significant (P less than 0.05) increase in stroke volume and central venous pressure, as well as significant decrease in pulmonary vascular resistance. These effects were sustained for 60 minutes, after which all variables returned toward preinfusion values. The hemodynamic response to HSS administration was suggestive of rapid plasma volume expansion and redistribution of cardiac output toward splanchnic circulation. Plasma volume expansion by HSS was minimal 60 minutes after resuscitation. Administration of ISS induced significant increase in cardiac index, stroke volume, femoral arterial blood flow, and urine production. These effects were sustained for 120 minutes, at which time, calves were euthanatized. Compared with HSS, ISS induced sustained increase in mean pulmonary arterial pressure and only a small increase in mesenteric arterial blood flow.(ABSTRACT TRUNCATED AT 250 WORDS)     

Clinical efficacy of intravenous hypertonic saline solution or hypertonic bicarbonate solution in the treatment of inappetent calves with neonatal diarrhea

BACKGROUND: The clinical efficacy of IV administered hypertonic saline solution and hypertonic bicarbonate solution (HBS) in the treatment of inappetent diarrheic calves has not been compared yet. HYPOTHESIS: HBS is more advantageous than hypertonic saline in the treatment of calves with severe metabolic acidosis. ANIMALS: Twenty-eight dehydrated, inappetent calves with neonatal diarrhea. METHODS: In 2 consecutive clinical studies, calves were initially treated with saline (5.85%; 5 mL/kg body weight [BW] over 4 minutes; study I: N = 16) or bicarbonate solution (8.4%; 10 mL/kg BW over 8 minutes; study II: N = 12), respectively, followed by oral administration of 3 L isotonic electrolyte solution 5 minutes after injection. Clinical and laboratory variables were monitored for 72 hours. RESULTS: Treatment failed in 6 calves of study I and in 1 calf of study II as indicated by a deterioration of the general condition. All treatment failures had more severe metabolic acidosis compared with successfully treated calves before treatment. In the latter, rehydration was completed within 18 hours after injection; metabolic acidosis was corrected within 24 hours (study I) and 6 hours (study II) after injection. CONCLUSIONS AND CLINICAL IMPORTANCE: Diarrheic calves with slight metabolic acidosis (base excess [BE] >-10 mM) can be treated successfully with hypertonic saline. HBS is appropriate in calves without respiratory problems with more severe metabolic acidosis (BE up to -20 mM). Intensive care of the calves is required to ensure a sufficient oral fluid intake after the initial IV treatment.     

Escherichia coli associated endotoxemia in dogs with parvovirus infection

Escherichia coli bacteremia and endotoxemia were observed in 3 adult mongrel dogs which had been prediagnosed as canine parvoviral disease. The endotoxin level was 46.5 pg/ml in the plasma of clinical cases, while 2.3 pg/ml in healthy controls. The microflora of the feces was confused in the clinical cases. The percentage of E. coli was major in the feces. Serologically similar strains were isolated from the blood. These strains did not produce enterotoxins such as heat-stable enterotoxin (ST) and heat-labile enterotoxin (LT). Histopathologically, the lesions in the small intestine consisted of epithelial degeneration and necrosis. Viral inclusion bodies were frequently observed in the epithelial cells. Disseminated intravascular coagulation was observed in various tissues including the liver and small intestinal submucosa. After experimental infection with CPV, all dogs showed various clinical signs. CPV was positive in the feces. Endotoxin level in the plasma gradually increased and high level continued for long period from 10 to 30 days. Mean maximum level of endotoxin in the experimental dogs was 73.6 pg/ml. These results indicate that intestinal flora plays a important role in the pathogenesis of CPV infection and that endotoxin is one of the factors which predispose to severe disease after the infection.     

Cardiovascular effects of 7.2% hypertonic saline solution in halothane anaesthetized ponies

The haemodynamic effects of intravenously (iv) administered hypertonic saline solution (7.2%, 4 ml/kg of body weight [bwt]) were investigated in normovolaemic ponies during halothane anaesthesia (dorsal recumbent position, intermittent pressure ventilation). Heart rate, arterial blood and pulmonary artery pressures, cardiac output, and arterial blood gases were measured throughout the experiment while related haemodynamic parameters (cardiac index, systemic and pulmonary vascular resistance, stroke volume, ventricular work) were calculated.
A transient decrease in arterial blood pressure occurred during the administration of the hypertonic solution. Significant increases in cardiac output and index, stroke work, and systolic arterial pressure were observed 5 min after the administration of the hypertonic infusion. A gradual normalization of the increased parameters occurred afterwards. Heart rate and arterial blood gases remained constant throughout the study. No clinical side-effects, except for an increase in urinary production in the recovery period, were seen during and after anaesthesia.     

Escherichia coli sepsis and endotoxemia in conscious young pigs

In conscious pigs the influence of intravenous infusion of live E. coli (7×10⁸/kg), of the equivalent amount of endotoxin (20 g/kg) or of a high dose of endotoxin (2.5 mg/kg) on the hemodynamic, clinical and pathological parameters and on survival rate was studied. E. coli and endotoxin infusion resulted in pulmonary hypertension, systemic arterial hypotension, a decrease in cardiac output and an increase in heart rate. Clinical signs were characterized by respiratory and nervous disturbances, whereas necropsy revealed hemorrhages and edema in several organs. Although these findings were similar in the three groups, a marked difference in lethality was observed. Infusion of E. coli or of the high dose of endotoxin resulted in a significant mortality, whereas all pigs survived the infusion of the low dose of endotoxin. This suggests that the lethal pathophysiological mechanisms may only become activated when a sufficient amount of endotoxin is released into the circulation.     

The effect of 7.2% hypertonic saline solution on m-mode echocardiographic indices in normovolemic dogs

This study investigated whether a small volume of 7.2% hypertonic saline solution (HSS) could affect M-mode echocardiographic indices in dogs. HSS induced significant increase in heart rate, stroke volume and cardiac index, when the fluid infusion was completed (P<0.05). In the HSS group, the left ventricular end-diastolic volume index, as an index of preload, significantly increased (P<0.05), whereas left ventricular end-systolic volume index were not altered. HSS induced slight increases in ejection fraction at end of infusion despite significantly differences were not observed. In conclusion, HSS did not induce a demonstrable effect on M-mode echocardiographic indices of systolic function-enhance cardiac contractility, but it caused preload augmentation that may contribute to an abrupt and transient increase in cardiac output just after HSS infusion.     

Effect of acute sublethal endotoxaemia on in vitro digital vascular reactivity in horses

Endotoxaemia is a syndrome linked to the development of equine laminitis; however, the relationship between them is uncertain. The aim of this experiment was to evaluate the effect of an experimental acute sublethal endotoxaemia model on in vitro equine palmar digital vascular reactivity. Rings of arteries and veins of each forelimb were obtained from 11 clinically healthy horses submitted to two surgical procedures, 3 weeks apart. Before the second surgery, 0.25 microg/kg of lipopolysaccharide from Escherichia coli O55:B5 in saline, was administered i.v. in 30 min. After 3 h, the vessels were harvested and submitted to in vitro vascular reactivity experiments and histopathology. The response to depolarizing Krebs solution (DKS, 40 mm), phenylephrine (PHE), acetylcholine (ACh) and sodium nitroprusside (SNP) were evaluated. All horses showed colic pain and watery diarrhoea, tachycardia, tachypnea, hyperthermia and leucopenia. Concentration-response curve (CRC) to PHE was shifted to the left in arteries rings from endotoxemic horses without any effect on vein rings. The CRC to ACh was shifted to the right with a reduction in the maximal response. The response to SNP and DKS was similar between groups. There was no evidence of histopathological effects. The increased response to PHE in digital arteries together with a reduction of the endothelium-dependent response to ACh in arteries and veins, confirm the existing reports where endotoxaemia was found to modify the digital vascular reactivity during the acute phase. As the digital endothelial function is impaired, there may be an increased potential to develop a digital prothrombotic state with a reduced vasodilatory capacity.     

Effect of environmental stress on the responses of ascorbic-acid-treated chickens to Escherichia coli challenge infection

As the stressfulness of the environment increased (measured as increasing heterophil/lymphocyte [H/L] ratios), resistance of chickens to Escherichia coli challenge infection increased. At a relatively low level of environmental stress (H/L ratio = 0.33), the incidence of severe lesions was 22% in chickens fed diets containing 330 mg of ascorbic acid (AA)/kg and 80% in undosed controls. As the level of environmental stress increased, the dose of AA required for maximum reduction of the incidence of severe lesions increased, and the difference in lesion incidence between AA-dosed and undosed chickens decreased. When environmental stress resulted in H/L ratios of 0.53 or more, AA did not ameliorate the severity of infection. At levels of stress characterized by H/L ratios between 0.39 and 0.44, increasing doses of AA resulted in increased susceptibility to E. coli until a dose associated with maximum susceptibility was reached. Further increases in the dose of AA resulted in decreased susceptibility until a dose associated with maximum resistance was reached. In chickens fed feed containing 15 mg corticosterone/kg, increasing doses of AA resulted in increasing susceptibility to E. coli.