Continuous Veno-venous Hemofiltration in Goat Model with Crush Syndrome

Tang Yi, ZHang Ling, Yang Ying-ying. et al

Abstract

Crush syndrome (CS) is a common critical condition. This study aimed to establish a crush syndrome goat model through muscle injection of glycerol and test the effect of continuous veno-venous hemofiltraion (CVVH).Methods 12 male goats at 12-15 months age were randomly assigned into control, model, and CVVH groups. After 2 weeks of normal feeding, the goats were weighed and stripped off foods for 24 h. Goats in the model and CVVH groups were then injected with 50% glycerol athind legs. Diagnosis of CS was established based on serum creatine kinase (CK) >1 000 U/L and serum creatinine (sCr) > 2 times of standard. No intervention was given to goats in the control group. A catheter was planted to get blood access.CVVH was administered using a Prisma-flex machine, with blood flow being set at 100 mL/min and replacement fluid with pre-dilution at 35 mL/(kg·h). After 23 h of treatment, the goats were sacrificed.Plasma and kidney samples were taken.Results Bloody urine hyperkalemia and decrease of urine volume were found in all of the goats injected with glycerol.Serum CK and sCr increased 1 h after the injection compared with the controls. After 23 h of CVVH treatment, serum CK and sCr decreased compared with goats in the model group. The light microscope revealed manifestation of tubular necrosis and interstitial edema, but the glomeruli were almost normal. The electronic microscope found prominent signs of cell apoptosis, such as chromatin aggregation, mitochondrial swelling, and endoplasmic reticulum expansion. Caspase12 expression in the goats with CS was significantly higher than that in the controls. The CVVH treated goats had lower level of expression than those in the model group (P＜0.05). TUNEL staining identified a higher proportion of renal cell apoptosis in the goats in the model group compared with those in the CVVH group.Conclusion Muscle injection with glycerol can induce CS in goats. Early CVVH intervention improves renal function and alleviates renal tubular cell apoptosis.

 

Keywords: Crush syndrome, Goat model, Acute kidney injury, Continuous veno-venous hemofiltration 

 

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