Evidence map›Paper›PMID 37733256›Full record

ArticleIntensive care medicine experimental2023

Fluid restrictive resuscitation with high molecular weight hyaluronan infusion in early peritonitis sepsis.

Annelie Barrueta Tenhunen, Jaap van der Heijden, Paul Skorup, Marco Maccarana, Anders Larsson, Anders Larsson, Gaetano Perchiazzi, Jyrki Tenhunen

Open access · goldAbstract read
In one paragraph

Article in Intensive care medicine experimental, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Annelie Barrueta TenhunenDepartment of Surgical Sciences, Division of Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden. annelie.barrueta@surgsci.uu.se.ORCID http://orcid.org/0000-0003-0815-375X
Jaap van der HeijdenDepartment of Surgical Sciences, Division of Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden.
Paul SkorupDepartment of Medical Sciences, Division of Infectious Diseases, Uppsala University, Uppsala, Sweden.
Marco MaccaranaDepartment of Medical Biochemistry and Microbiology, The Biomedical Center, University of Uppsala, Uppsala, Sweden.
Anders LarssonDepartment of Medical Sciences, Division of Clinical Chemistry, Uppsala University, Uppsala, Sweden.
Anders LarssonHedenstierna Laboratory, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Gaetano PerchiazziDepartment of Surgical Sciences, Division of Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden.
Jyrki TenhunenDepartment of Surgical Sciences, Division of Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden.
Uppsala University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Sepsis is a condition with high morbidity and mortality. Prompt recognition and initiation of treatment is essential. Despite forming an integral part of sepsis management, fluid resuscitation may also lead to volume overload, which in turn is associated with increased mortality. The optimal fluid strategy in sepsis resuscitation is yet to be defined. Hyaluronan, an endogenous glycosaminoglycan with high affinity to water is an important constituent of the endothelial glycocalyx. We hypothesized that exogenously administered hyaluronan would counteract intravascular volume depletion and contribute to endothelial glycocalyx integrity in a fluid restrictive model of peritonitis. In a prospective, blinded model of porcine peritonitis sepsis, we randomized animals to intervention with hyaluronan (n = 8) or 0.9% saline (n = 8). The animals received an infusion of 0.1% hyaluronan 6 ml/kg/h, or the same volume of saline, during the first 2 h of peritonitis. Stroke volume variation and hemoconcentration were comparable in the two groups throughout the experiment. Cardiac output was higher in the intervention group during the infusion of hyaluronan (3.2 ± 0.5 l/min in intervention group vs 2.7 ± 0.2 l/min in the control group) (p = 0.039). The increase in lactate was more pronounced in the intervention group (3.2 ± 1.0 mmol/l in the intervention group and 1.7 ± 0.7 mmol/l in the control group) at the end of the experiment (p < 0.001). Concentrations of surrogate markers of glycocalyx damage; syndecan 1 (0.6 ± 0.2 ng/ml vs 0.5 ± 0.2 ng/ml, p = 0.292), heparan sulphate (1.23 ± 0.2 vs 1.4 ± 0.3 ng/ml, p = 0.211) and vascular adhesion protein 1 (7.0 ± 4.1 vs 8.2 ± 2.3 ng/ml, p = 0.492) were comparable in the two groups at the end of the experiment. In conclusion, hyaluronan did not counteract intravascular volume depletion in early peritonitis sepsis. However, this finding is hampered by the short observation period and a beneficial effect of HMW-HA in peritonitis sepsis cannot be discarded based on the results of the present study.

Indexed as

Animal modelColloidFluid therapyGlycocalyxInflammation

Identifiers

PMID37733256
PMCPMC10513979
OpenAlexW4386910349

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.