Effect of controlled hypotensive hemorrhage on plasma sodium levels in anesthetized pigs: An exploratory study

Rafael T. Krmar*, Stephanie Franzén, Leif Karlsson, Helin Strandberg, Susanna Törnroth-Horsefield, Jesper K. Andresen, Boye L. Jensen, Mattias Carlström, Robert Frithiof

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

19 Downloads (Pure)

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 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.

Original languageEnglish
Article numbere15886
JournalPhysiological Reports
Volume11
Issue number22
Number of pages13
ISSN2051-817X
DOIs
Publication statusPublished - Nov 2023

Keywords

  • aquaporin 2
  • hemorrhage
  • hyponatremia
  • pig model
  • renin-angiotensin aldosterone
  • vasopressin-neurophysin 2-copeptin

Fingerprint

Dive into the research topics of 'Effect of controlled hypotensive hemorrhage on plasma sodium levels in anesthetized pigs: An exploratory study'. Together they form a unique fingerprint.

Cite this