Increasing tourniquet number has no effect on amikacin concentration within the radiocarpal joint in horses undergoing intravenous regional limb perfusion.
Abstract: To determine whether IV regional limb perfusion (IVRLP) performed in the cephalic vein with a wide rubber tourniquet (WRT) applied proximal and distal to the carpus results in a higher peak concentration (Cmax) of amikacin in the radiocarpal joint (RCJ), compared with the Cmax for IVRLP using a single WRT proximal to the carpus. Methods: 7 healthy adult horses. Methods: Horses underwent IVRLP using standing sedation with 2 g of amikacin sulfate diluted to 60 mL by use of saline (0.9% NaCl) solution in the cephalic vein with 2 different tourniquet techniques; proximal WRT (P) and proximal and distal WRT (PD). Synovial fluid was collected from the RCJ at 5, 10, 15, 20, 25, and 30 minutes after IVRLP. Tourniquets were removed after the 30-minute sample was collected. Blood samples from the jugular vein were collected at 5, 10, 15, 20, 25, 29, and 31 minutes after IVRLP. Amikacin concentration was quantified by a fluorescence polarization immunoassay. Median peak concentration (Cmax) of amikacin and time to maximum drug concentration (Tmax) within the RCJ were determined. Results: Median peak concentration in the RCJ was 1331.4 μg/mL with technique P and 683.1 μg/mL with technique PD. Median Tmax occurred at 30 minutes with technique P and 25 minutes with technique PD. No significant (Cmax, P = 0.18; Tmax, P = 0.6) difference in amikacin Cmax or Tmax between techniques was detected. Conclusions: Placement of 2 WRTs offers no advantage to a single proximal WRT when performing IVRLP to deliver maximal amikacin concentrations to the RCJ using IVRLP.
Publication Date: 2022-02-02 PubMed ID: 35113796DOI: 10.2460/ajvr.21.08.0110Google Scholar: Lookup
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- Journal Article
Summary
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The article discusses a study that investigated whether using two wide rubber tourniquets (WRTs) in intravenous regional limb perfusion (IVRLP) in horses would result in a higher concentration of amikacin antibiotic in the radiocarpal joint (RCJ, the wrist equivalent in horses) compared to a single tourniquet. The authors concluded that the use of two tourniquets did not provide any additional benefits compared to a single tourniquet in terms of achieving maximum amikacin concentration.
Study Design
- This study used 7 healthy adult horses. The IVRLP process was carried out while the horses were sedated and standing. The amikacin antibiotic was administered through the cephalic vein (a vein located on the forelimb) and two tourniquet techniques were compared: a single proximal WRT (P) and a proximal with a distal WRT (PD).
- To determine antibiotic concentration, synovial fluid samples were collected from the RCJ at intervals of 5 minutes from 5 minutes up to 30 minutes after IVRLP, while blood samples were collected from the jugular vein at similar time intervals.
- Amikacin concentration in the samples was quantified using fluorescence polarization immunoassay, a sensitive method used to detect the concentration of specific substances in a sample.
Findings
- The study found no significant difference in the peak concentration of amikacin or the time taken to reach maximum concentration (Tmax) between the two tourniquet techniques.
- The median peak amikacin concentration in the RCJ was higher using the single WRT technique (1331.4 μg/mL) compared to the two WRT technique (683.1 μg/mL). Likewise, the median Tmax was 30 minutes using the single WRT technique and 25 minutes using the two WRT technique.
Conclusion
- The researchers concluded that using two WRTs provided no advantage over a single proximal WRT to achieve maximum amikacin concentration in the RCJ when performing IVRLP.
- This means that the simpler approach of using a single tourniquet method is sufficient for treating infections in the joint of horses using the IVRLP technique.
Cite This Article
APA
Bergstrom TC, Kilcoyne I, Magdesian KG, Nieto JE.
(2022).
Increasing tourniquet number has no effect on amikacin concentration within the radiocarpal joint in horses undergoing intravenous regional limb perfusion.
Am J Vet Res, 83(4), 364-370.
https://doi.org/10.2460/ajvr.21.08.0110 Publication
Researcher Affiliations
- William R. Prichard Veterinary Medical Teaching Hospital, University of California-Davis, Davis, CA.
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA.
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA.
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA.
MeSH Terms
- Amikacin
- Animals
- Anti-Bacterial Agents
- Forelimb / blood supply
- Horses
- Perfusion / veterinary
- Synovial Fluid
- Tourniquets / veterinary
Citations
This article has been cited 1 times.- O'Brien M, Mochel JP, Kersh K, Wang C, Troy J. Phenylbutazone concentrations in synovial fluid following administration via intravenous regional limb perfusion in the forelimbs of six adult horses.. Front Vet Sci 2023;10:1236976.
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