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Sequential changes in renal oxygen consumption and sodium transport during hyperdynamic sepsis in sheep
A Weber1, I M Schwieger, O Poinsot
1Department of Surgery and Anesthesiology, University Medical Center, Geneva, Switzerland.
The American Journal of Physiology
|June 1, 1992
Summary
This study in sheep shows that progressive hyperdynamic sepsis impairs renal oxygen delivery and function, leading to reduced kidney oxygen consumption and creatinine clearance despite preserved tubular sodium reabsorption.
Area of Science:
- Physiology
- Sepsis Research
- Renal Function
Background:
- Sepsis is a life-threatening condition characterized by dysregulated host response to infection.
- Hyperdynamic sepsis involves increased cardiac output and decreased systemic vascular resistance.
- Understanding the impact of sepsis on organ-specific oxygen metabolism and function is crucial.
Purpose of the Study:
- To investigate the sequential changes in systemic and renal oxygen delivery (QO2) and consumption (VO2).
- To assess the effects of progressive hyperdynamic sepsis on renal function in an ovine model.
- To evaluate the relationship between oxygen metabolism and tubular function during sepsis.
Main Methods:
- Utilized a chronic ovine model with instrumentation for continuous monitoring.
- Administered intravenous Escherichia coli endotoxin infusion for 3 days to induce progressive hyperdynamic sepsis.
- Measured systemic and renal hemodynamics, oxygen delivery and consumption, plasma creatinine clearance, and sodium excretion.
Main Results:
- Systemic blood pressure and vascular resistance decreased significantly, while systemic oxygen delivery increased.
- Renal blood flow, renal oxygen delivery, and renal oxygen consumption decreased significantly within the first 12 hours.
- Plasma creatinine clearance was markedly reduced, and sodium excretion was significantly diminished, indicating preserved tubular function despite impaired oxygen supply.
- The kidney's efficiency in reabsorbing sodium relative to oxygen consumed was transiently reduced.
Conclusions:
- Progressive hyperdynamic sepsis leads to significant reductions in renal oxygen delivery and consumption.
- Despite impaired renal oxygenation and function, tubular sodium handling is largely preserved.
- The observed changes highlight the complex interplay between systemic hemodynamics, oxygen metabolism, and renal function during sepsis.