Köpeklerde deneysel olarak oluşturulan septik şokun sağaltımında Dobutamine, Flunixin, Meglumine, Methylprednisolone ve Enalapril`in etkileri

Abstract

SUMMARY In experimentally septic shock induced dogs, establishment of early diagnostic criteria and comparison of the affects of different treatment combinations at the beginning of the septic shock were aimed in this study. Thirty dogs of both sexes and different ages were used in the study. To clinically and hematologically controlled each dogs, 5x1 09 Escherichia coli bacteria/kg were given via intravenous route and approximately within one hour the septic shock was induced. Five groups each composed of 6 dogs were designed, and to I th group (control group) only antibiotic and fluid therapy was performed. To rest of the groups, along with antibiotic and fluid therapy, at the beginning dobutamin (10 meg/kg/min, i.v.) was given. Additionally, methylprednisolone sodium succinate (in the shock phase 30 mg/kg, i.v.), flunixin meglumin (in the shock phase and 2 nd and 12 th hours of the shock 1.5 mg/kg, i.v.), and enalapril (after 24 th hour 0.5 mg/kg, Per oral in every 12 hours), were utilized to the III. rd, IV. th and V. th groups, respectively. All the dogs were examined regarding for clinical, hematological and biochemical parameters before and at the septic shock phase and also at the 1 st, 4 th. 12 th, 24 th, 36 th, 48 th, 72 nd, 96 th and 120 th hours after the application of first treatment. Plasma volume was calculated from hematocrit and hemoglobin values. During the septic shock high fever, increased heart and respiratory rates, weakned heart beat and peripheral pulse, prolonged capillary refilling time, leukopenia, neutropenia, thrombocytopenia, plasma volume decrease and increased hematocrit (p<0.001) hemoglobin (p<0.01) values, red blood cell counts, AST and lactic acid levels (pO.OOl) were observed.ÖZET Bu çalışmada deneysel olarak septik şok oluşturulan köpeklerde erken tanı kriterlerinin ortaya konması ve septik şokun başlangıcında farklı sağaltım kombinasyonları uygulanarak etkilerinin karşılaştırılması amaçlanmıştır. Çalışmada her iki cinsiyetten, farklı yaştan 30 melez köpek kullanıldı. Klinik ve hematolojik olarak kontrol edilen köpeklere intravenöz (i.v.) yolla 5x1 09 adet/kg'a E. coli verildi ve ortalama bir saatte septik şok oluşturuldu. Herbiri altışar köpek içeren 5 grup oluşturularak, I. gruba (kontrol grubu) yalnız antibiyotik ve sıvı sağaltımı uygulandı. II. gruba antibiyotik ve sıvı sağaltımı ile birlikte başlangıçta dobutamin (10 mcg/kg/dk, i.v.) verildi. II. Gruptaki sağaltım planına ilave olarak ta III. grupta metilprednisolon sodyum süksinat (şok anında 30 mg/kg, i.v.), IV. grupta flunixin meglumin (şok anı, 2. ve 12. saatlerde 1.5 mg/kg, i.v.) ve V. grupta enalapril (24. saatten itibaren 12 saatte bir 0.5 mg/kg, oral) kullanıldı. Tüm köpekler deneme öncesi, septik şok oluştuğunda, ilk sağaltımdan sonraki 1, 4, 12, 24, 36, 48, 72, 96 ve 120. saatlerde klinik, hematolojik ve biyokimyasal parametreler yönünden muayene edildi. Hematokrit ve hemoglobin değerlerinden plazma volümü hesaplandı. Septik şok anında yüksek ateş, kalp ve solunum frekansının artışı, kalp vurumlarının ve periferal nabız kalitesinin zayıflaması, kapillar dolma zamanının uzaması, lökopeni, nötropeni, trombositopeni, plazma volümünde azalma ve hematokrit (pO.001), hemoglobin (p<0.01), eritrosit, AST ve laktik asit düzeylerinin arttığı gözlendi (pO.001). Farklı sağaltım kombinasyonları uygulandıktan sonra, değerlendirilen parametrelerin bir çoğunda gruplar arasında ve gruplar içi önemli farklılıkların yanında, özellikle kapillar dolma zamanının II. grupta 24. saatten itibaren (pO.001),

SUMMARY In experimentally septic shock induced dogs, establishment of early diagnostic criteria and comparison of the affects of different treatment combinations at the beginning of the septic shock were aimed in this study. Thirty dogs of both sexes and different ages were used in the study. To clinically and hematologically controlled each dogs, 5x1 09 Escherichia coli bacteria/kg were given via intravenous route and approximately within one hour the septic shock was induced. Five groups each composed of 6 dogs were designed, and to I th group (control group) only antibiotic and fluid therapy was performed. To rest of the groups, along with antibiotic and fluid therapy, at the beginning dobutamin (10 meg/kg/min, i.v.) was given. Additionally, methylprednisolone sodium succinate (in the shock phase 30 mg/kg, i.v.), flunixin meglumin (in the shock phase and 2 nd and 12 th hours of the shock 1.5 mg/kg, i.v.), and enalapril (after 24 th hour 0.5 mg/kg, Per oral in every 12 hours), were utilized to the III. rd, IV. th and V. th groups, respectively. All the dogs were examined regarding for clinical, hematological and biochemical parameters before and at the septic shock phase and also at the 1 st, 4 th. 12 th, 24 th, 36 th, 48 th, 72 nd, 96 th and 120 th hours after the application of first treatment. Plasma volume was calculated from hematocrit and hemoglobin values. During the septic shock high fever, increased heart and respiratory rates, weakned heart beat and peripheral pulse, prolonged capillary refilling time, leukopenia, neutropenia, thrombocytopenia, plasma volume decrease and increased hematocrit (p<0.001) hemoglobin (p<0.01) values, red blood cell counts, AST and lactic acid levels (pO.OOl) were observed.SUMMARY In experimentally septic shock induced dogs, establishment of early diagnostic criteria and comparison of the affects of different treatment combinations at the beginning of the septic shock were aimed in this study. Thirty dogs of both sexes and different ages were used in the study. To clinically and hematologically controlled each dogs, 5x1 09 Escherichia coli bacteria/kg were given via intravenous route and approximately within one hour the septic shock was induced. Five groups each composed of 6 dogs were designed, and to I th group (control group) only antibiotic and fluid therapy was performed. To rest of the groups, along with antibiotic and fluid therapy, at the beginning dobutamin (10 meg/kg/min, i.v.) was given. Additionally, methylprednisolone sodium succinate (in the shock phase 30 mg/kg, i.v.), flunixin meglumin (in the shock phase and 2 nd and 12 th hours of the shock 1.5 mg/kg, i.v.), and enalapril (after 24 th hour 0.5 mg/kg, Per oral in every 12 hours), were utilized to the III. rd, IV. th and V. th groups, respectively. All the dogs were examined regarding for clinical, hematological and biochemical parameters before and at the septic shock phase and also at the 1 st, 4 th. 12 th, 24 th, 36 th, 48 th, 72 nd, 96 th and 120 th hours after the application of first treatment. Plasma volume was calculated from hematocrit and hemoglobin values. During the septic shock high fever, increased heart and respiratory rates, weakned heart beat and peripheral pulse, prolonged capillary refilling time, leukopenia, neutropenia, thrombocytopenia, plasma volume decrease and increased hematocrit (p<0.001) hemoglobin (p<0.01) values, red blood cell counts, AST and lactic acid levels (pO.OOl) were observed.