Estudo comparativo da eficácia do dreno de Blake e cateter Tenckhoff na diálise peritoneal em coelhos (Oryctolagus cuniculus) hígidos.
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Data
2021-03-30
Autores
Pereira, Ana Camila
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Universidade Estadual Paulista (Unesp)
Resumo
A diálise peritoneal é uma terapia de substituição renal capaz de remover as toxinas urêmicas, que utiliza o peritônio na realização das trocas de solutos e líquidos, sua principal indicação na veterinária é nos casos de lesão renal aguda. Este estudo teve como objetivo avaliar a técnica de diálise peritoneal com a utilização do cateter Tenckhoff e o dreno de Blake comparando a eficácia de drenagem e possíveis complicações. Vinte coelhos machos hígidos foram selecionados e alocados em dois grupos experimentais, grupo Tenckhoff (n=10) e grupo Blake (n=10). Foi realizada uma sessão de diálise peritoneal por dia composta por quatro ciclos de infusão, permanência e drenagem. As sessões de diálise peritoneal ocorreram em três dias consecutivos, correspondente aos dias D1, D2, D3 (primeiro, segundo e terceiro dia de diálise). Exames como hemograma, ureia, creatinina, alanina aminotransferase, albumina, potássio e urinálise foram realizados antes e após cada sessão, o líquido peritoneal foi coletado no pós de cada sessão para cultura e contagem de células. A análise estatística dos exames, realizada comparando o pós com o pré de todas as sessões dos grupos Blake e Tenckhoff, revelou uma redução do valor sérico de ureia no grupo Tenckhoff no D2, assim como para os valores séricos de albumina em ambos grupos. Em relação a eficácia de drenagem (ml/kg) o dreno de Blake apresentou um aumento de volume drenado quando comparado ao Tenckhoff na segunda sessão (3º e 4º ciclos) e na terceira sessão (1 e 2º ciclos). O cateter Tenckhoff apresentou maiores complicações com relação a retenção de líquido no abdome, ou seja, redução da eficácia de drenagem, enquanto o Blake apresentou uma maior tendência ao extravasamento do líquido peritoneal. Considerando a quantidade drenada de líquido peritoneal em cada grupo, o grupo Blake apresentou maior eficácia, pois obteve maior volume drenado quando comparado o resultado na relação líquido infundido x líquido drenado e menores complicações no que diz respeito a obstrução do fluxo. Sendo assim, conclui-se que o dreno Blake apresentou melhor performance em relação ao cateter Tenckhoff, pois revelou uma drenagem maior do dialisato durante a técnica de diálise peritoneal em coelhos hígidos.
Peritoneal dialysis is a renal replacement therapy capable of removing uremic toxins, which uses the peritoneum in the exchange of solutes and liquids, its main indication in the veterinary is in cases of acute kidney injury. This study aimed to evaluate the peritoneal dialysis technique with the use of the Tenckhoff catheter and the Blake drain, comparing the drainage efficacy and possible complications. Twenty healthy male rabbits were selected and allocated to two experimental groups, Tenckhoff group (n = 10) and Blake group (n = 10). One peritoneal dialysis session per day was made up of four cycles of infusion, permanence and drainage. Peritoneal dialysis sessions took place on three consecutive days, corresponding to days D1, D2, D3 (first, second and third day of dialysis). Tests such as blood count, urea, creatinine, alanine aminotransferase, albumin, potassium and urinalysis were performed before and after each session, the peritoneal fluid was collected at the end of each session for culture and cell counting. The statistical analysis of the exams, carried out by comparing the powder with the pre for all sessions of the Blake and Tenckhoff groups, revealed a reduction in the serum urea value in the Tenckhoff group in D2, as well as for the serum albumin values in both groups. Regarding the drainage efficacy (ml / kg), Blake's drain presented an increase in drained volume when compared to Tenckhoff in the second session (3rd and 4th cycles) and in the third session (1st and 2nd cycles). The Tenckhoff catheter presented major complications with respect to fluid retention in the abdomen, that is, reduced drainage efficacy, while Blake presented a greater tendency for peritoneal fluid to leak. Considering the amount of peritoneal fluid drained in each group, the Blake group showed greater efficacy, as it obtained a greater drained volume when comparing the result in the infused liquid x drained liquid ratio and less complications with regard to flow obstruction. Thus, it is concluded that the Blake drain performed better than the Tenckhoff catheter, as it revealed a greater drainage of the dialysate during the peritoneal dialysis technique in healthy rabbits.
Peritoneal dialysis is a renal replacement therapy capable of removing uremic toxins, which uses the peritoneum in the exchange of solutes and liquids, its main indication in the veterinary is in cases of acute kidney injury. This study aimed to evaluate the peritoneal dialysis technique with the use of the Tenckhoff catheter and the Blake drain, comparing the drainage efficacy and possible complications. Twenty healthy male rabbits were selected and allocated to two experimental groups, Tenckhoff group (n = 10) and Blake group (n = 10). One peritoneal dialysis session per day was made up of four cycles of infusion, permanence and drainage. Peritoneal dialysis sessions took place on three consecutive days, corresponding to days D1, D2, D3 (first, second and third day of dialysis). Tests such as blood count, urea, creatinine, alanine aminotransferase, albumin, potassium and urinalysis were performed before and after each session, the peritoneal fluid was collected at the end of each session for culture and cell counting. The statistical analysis of the exams, carried out by comparing the powder with the pre for all sessions of the Blake and Tenckhoff groups, revealed a reduction in the serum urea value in the Tenckhoff group in D2, as well as for the serum albumin values in both groups. Regarding the drainage efficacy (ml / kg), Blake's drain presented an increase in drained volume when compared to Tenckhoff in the second session (3rd and 4th cycles) and in the third session (1st and 2nd cycles). The Tenckhoff catheter presented major complications with respect to fluid retention in the abdomen, that is, reduced drainage efficacy, while Blake presented a greater tendency for peritoneal fluid to leak. Considering the amount of peritoneal fluid drained in each group, the Blake group showed greater efficacy, as it obtained a greater drained volume when comparing the result in the infused liquid x drained liquid ratio and less complications with regard to flow obstruction. Thus, it is concluded that the Blake drain performed better than the Tenckhoff catheter, as it revealed a greater drainage of the dialysate during the peritoneal dialysis technique in healthy rabbits.
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Palavras-chave
Drenagem, Lesão renal aguda, Peritônio, Terapia de reposição renal, Toxinas urêmicas, Drainage, Acute kidney injury, Peritoneum