Effects of haemorrhage and lactated Ringer's solution or tetrastarch 130/0.4 resuscitation on colloidal osmotic pressure and osmolality in cats.

Abstract

ObjectivesTo determine the effects of haemorrhage and fluid over-resuscitation on colloidal osmotic pressure of albumin (COP albumin), plasma (Posm) and effective (Eosm) osmolality in anaesthetised cats.MethodsA total of six cats were given three treatments once, at 2-month intervals, in a randomised, crossover haemorrhage-resuscitation study. The treatments were divided into two phases, a controlled haemorrhage phase and a fluid resuscitation phase, as follows: (1) NoHR&#x2009;=&#x2009;no controlled haemorrhage and no resuscitation; (2) LRS&#x2009;=&#x2009;controlled haemorrhage followed by lactated Ringer's solution infusion (60&#x2009;ml/kg/h); and (3) TS&#x2009;=&#x2009;controlled haemorrhage followed by 6% tetrastarch 130/0.4 suspended in 0.9% saline infusion (20&#x2009;ml/kg/h). The resuscitation fluids were administered for 120&#x2009;mins. Data were collected before haemorrhage, before resuscitation and at 30&#x2009;min intervals until 120&#x2009;mins. Variables were calculated at each time point as follows: COP albumin&#x2009;=&#x2009;albumin concentration (g/l)&#x2009;&#xd7;&#x2009;0.57; Posm&#x2009;=&#x2009;(2&#x2009;&#xd7;&#x2009;sodium)&#x2009;+&#x2009;glucose&#x2009;+&#x2009;blood urea nitrogen; and Eosm&#x2009;=&#x2009;(2&#x2009;&#xd7;&#x2009;sodium)&#x2009;+&#x2009;glucose. All Posm and Eosm concentrations were measured as mmol/l. Data were compared using a general linear mixed model (significance:<0.05).ResultsMean&#x2009;&#xb1;&#x2009;SD total haemorrhage volumes for NoHR, LRS and TS were 10.2&#x2009;&#xb1;&#x2009;2.3, 29.3&#x2009;&#xb1;&#x2009;9.0 and 29.1&#x2009;&#xb1;&#x2009;6.3&#x2009;ml/kg, respectively. The COP albumin decreased over time in all treatments regardless of volumes of blood lost and fluid administered. The decrease in COP albumin was profound and clinically relevant in LRS and TS (both<0.001). There were no statistical differences in Posm and Eosm over time except in LRS at 90 (&#x2009;=&#x2009;0.004) and 120&#x2009;ml/kg (<0.001).Conclusions and relevanceThe COP albumin decreased in all treatments but to low and clinically relevant concentrations in LRS and TS, putting the cats at risk of fluid overload. There were no clinically relevant derangements in Posm and Eosm.