1. Effects of N-acetylcysteine (NAC) supplementation in resuscitation fluids on renal microcirculatory oxygenation, inflammation, and function in a rat model of endotoxemia
- Author
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Philippe Guerci, Frank Nocken, Asli Kandil, Cihan Demirci-Tansel, Ebru Gurel-Gurevin, Bulent Ergin, Lara Zafrani, Can Ince, Graduate School, Other departments, Amsterdam Cardiovascular Sciences, and Translational Physiology
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Resuscitation ,Renal cortex ,030204 cardiovascular system & hematology ,Pharmacology ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,0302 clinical medicine ,Kidney oxygenation ,Sepsis ,medicine ,Inflammation ,Kidney ,business.industry ,Septic shock ,Research ,Acute kidney injury ,030208 emergency & critical care medicine ,Oxygenation ,medicine.disease ,N-acetylcysteine ,Oxygen tension ,medicine.anatomical_structure ,Anesthesia ,Renal vein ,business - Abstract
Background Modulation of inflammation and oxidative stress appears to limit sepsis-induced damage in experimental models. The kidney is one of the most sensitive organs to injury during septic shock. In this study, we evaluated the effect of N-acetylcysteine (NAC) administration in conjunction with fluid resuscitation on renal oxygenation and function. We hypothesized that reducing inflammation would improve the microcirculatory oxygenation in the kidney and limit the onset of acute kidney injury (AKI). Methods Rats were randomized into five groups (n = 8 per group): (1) control group, (2) control + NAC, (3) endotoxemic shock with lipopolysaccharide (LPS) without fluids, (4) LPS + fluid resuscitation, and (5) LPS + fluid resuscitation + NAC (150 mg/kg/h). Fluid resuscitation was initiated at 120 min and maintained at fixed volume for 2 h with hydroxyethyl starch (HES 130/0.4) dissolved in acetate-balanced Ringer’s solution (Volulyte) with or without supplementation with NAC (150 mg/kg/h). Oxygen tension in the renal cortex (CμPO2), outer medulla (MμPO2), and renal vein was measured using phosphorimetry. Biomarkers of renal injury, inflammation, and oxidative stress were assessed in kidney tissues. Results Fluid resuscitation significantly improved the systemic and renal macrohemodynamic parameters after LPS. However, the addition of NAC further improved cortical renal oxygenation, oxygen delivery, and oxygen consumption (p
- Published
- 2016
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