Research Information System
ESICM LIVES 2024, Barcelona, Spain, 3 - 09 October 2024, pp.83-84, (Summary Text)
Introduction: Renal ischemic reperfusion (IR) injury is one of the major sources of renal cell injury and can lead to renal failure associated with acute kidney injury (AKI). Acute normovolemic hemodilution (ANH) is a blood conservation technique shown to reduce transfusion and bleeding associated with surgery. Despite numerous advantages of hemodilution, little is known about the effect of ANH on renal failure associated with ischemia. Objectives: In our study, we aimed to evaluate the relationship between fluid administration and I/R injury through thermal imaging. Methods: Anesthetized Wistar albino rats (n = 7) were divided into 7 groups: Sham-operated control (C), aortic occlusion (30 min) (ISC), 90 min reperfusion following aortic occlusion (30 min) (I/R), ANH induced by normal saline (NS) (HEM-1), ANH induced by a balanced crystalloid solution (HEM-2), ANH induced by NS following I/R (HEM-1 + ISC), and ANH induced by a balanced solution following I/R (HEM-2 + ISC). Hemodilution was targeted at a hematocrit level of 25%. Besides systemic hemodynamic parameters, serum creatinine and urea levels as indicators of renal dysfunction were measured. Also, renal tissue thermal characteristics were determined by thermal imaging. Results: The target hematocrit levels were successfully achieved, resulting in a significant decrease in the hemodilution groups. When the fluid volumes and hemodilution periods were compared in the hemodilution groups, no significant difference was found to be among the HEM-1, HEM-2, HEM-1 + ISC, and HEM-2 + ISC groups. Mean arterial pressure (MAP) showed significant differences compared to respective baseline levels in all intervention groups (I/R, p < 0.01; HEM-1, p < 0.01; HEM-1 + ISC, p < 0.001; HEM-2, p < 0.05 and HEM-2 + ISC, p < 0.01). However, the urea/creatinine ratios in the I/R, HEM-1, HEM-1 + ISC and HEM-2 + ISC groups were higher compared to their respective baselines (p < 0.05). In addition, mean temperatures showed significant decreases compared to respective baseline temperatures in the I/R, HEM-1, HEM-1 + ISC, and HEM-2 + ISC groups. Conclusions: Regardless of fluid type and presence of ischemic period, fluid administration affects macrohemodynamics. Ischemic damage cannot be prevented by fluid administration. Moreover, thermal imaging can be a monitoring tool for kidney function during surgical scenarios.
Keywords: renal ischemia/reperfusion, thermal imaging, hemodilution.