Estudo clínico da aplicação sequencial de salina hipertônica 7,5% sobre a resposta clínica e hemograma de cães em terapia para sepse grave decorrente da síndrome da diarreia hemorrágica aguda

Abstract

At the clinic of pets is a high frequency of dogs with hemorrhagic syndrome of acute diarrhea associated with sepsis, which causes high mortality. In such events, there is an imbalance between the production and release of pro- and anti-inflammatory cytokines. Thus, the use of immunomodulatory substances becomes important in these patients, highlighted the hypertonic saline solution, which in addition to providing interference in hemodynamic, has shown to have an anti-inflammatory potential. In this context, the aim of, in a randomized controlled trial single center (UFMG Veterinary Hospital), study the immunomodulatory effects of the addition of hypertonic saline 7.5% sequentially at 24 and 48 hours after starting standard treatment on clinical variables and complete blood count in dogs with severe sepsis due to acute hemorrhagic enteritis syndrome. To this end, 12 dogs were randomly divided into two groups, a control (CON) and one with hypertonic saline 7.5% (SSH). It was evaluated at zero time (T 0), 24 hours (T24), 48 hours (T48) and 72 hours (T72), being collected clinical and laboratory data for the experiment. The NOC group received, in addition to standard treatment, lactated Ringer's solution bolus of 5 mL / kg for 4 minutes in the T24 and T48, and SSH group received SSH 7.5% bolus, also in T24 and T48 volume 5 mL / kg for 4 minutes. As the objective is to analyze the delayed effect of TSH 7.5%, the collections in each time were made prior to the administration of the bolus in both groups. We evaluated complete blood count and clinical variables as AVDN scale, degree of dehydration, heart rate (HR), systolic blood pressure (SBP), respiratory rate (f) and rectal temperature (RT). Parametric data passed by analysis of variance in blocks and later Student Newman Keuls test aiming to verify the effect of time in each group. To check the effect of treatment in each time held the Student t test. The nonparametric data subjected to Friedman's test for effect of time and Mann Whitnay test for each treatment time. Variables without normal distribution took place logarithmic transformation. All analyzes were considered with p = 0.05 significance level. As a result of the clinical variables, there was a significant difference in the HSS group with an elevation of SBP and HR reduction, which was not observed in the CON group. Regarding the red blood count number, hematocrit also fell in both groups at T24, hemoglobin fell to the CON group at T24, but in SSH group only in T48. The variables of white series total leukocytes SSH group showed a significant increase, being within the normal range in the T72, which was not observed in the CON group. Segmented showed no significant difference, but the SSH group had an increase of 9.5 times in T72 compared to T24 and the CON group increased by only 2.5 times in the same time (P = 0.09). SSH group showed a significant increase in monocytes in the T-72 compared to the T24, since the CON group did not achieve the same performance. Platelets in the CON group decreased in the course of time, but in the HSS group remained stable. The variables total protein (TP) and albumin in both groups showed a significant reduction in comparison of T24 with T0, but the globulin variable in the CON group observed a significant reduction compared to T0, and SSH group remained stable during all the Times. Thus, the SSH 7.5% becomes a promising alternative for the treatment of dogs with acute hemorrhagic enteritis syndrome. presenting beneficial hemodynamic results and immunomodulators