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The Canadian veterinary journal = La revue veterinaire canadienne2013; 54(4); 363-367;

The influence of perfusate volume on antimicrobial concentration in synovial fluid following intravenous regional limb perfusion in the standing horse.

Abstract: This study investigated the influence of perfusate volume on antimicrobial concentration in synovial fluid following intravenous regional limb perfusion (IVRLP) and assessed the efficacy of low volume IVRLP. The front limbs of 9 horses were randomly assigned to 1 of 3 volume groups: 10 mL (Group 1), 30 mL (Group 2), or 60 mL (Group 3). A tourniquet was applied distal to the carpus and the limbs were perfused with 500 mg genta-micin diluted to the assigned volume via a catheter placed in the lateral palmar digital vein at the level of the proximal sesamoid bones. Synovial fluid samples were collected from the metacarpophalangeal joint at 30 minutes, followed by removal of the tourniquet. Gentamicin concentration in synovial fluid was detected using a fluorescence polarization immunoassay. There were no statistically significant differences among gentamicin concentrations in synovial fluid among perfusate volume groups. Mean gentamicin concentration in Group 1 (125.9 μg/mL) was higher than Group 2 (82.7 μg/mL) and Group 3 (56.1 μg/mL). Cette étude a étudié l’influence du volume perfusé sur la concentration antimicrobienne dans le liquide synovial après la perfusion intraveineuse régionale d’un membre (PIRM) et a évalué l’efficacité d’un faible volume de PIRM. Les membres antérieurs de 9 chevaux ont été assignés au hasard à 1 de 3 groupes de volume: 10 ml (Groupe 1), 30 ml (Groupe 2) ou 60 ml (Groupe 3). Un tourniquet a été appliqué en aval du carpe et les membres ont été perfusés avec 500 mg de gentamicine diluée au volume assigné par un cathéter placé dans la veine digitale palmaire latérale au niveau des os sésamoïdes proximaux. Les échantillons de liquide synovial ont été prélevés de l’articulation métacarpo-phalangienne à 30 minutes, suivis de l’enlèvement du tourniquet. La concentration de gentamicine dans le liquide synovial a été détectée à l’aide d’un immuno-essai par fluorescence polarisée. Il n’y avait pas de différences statistiquement significatives entre les concentrations de gentamicine dans le liquide synovial parmi les groupes de volume perfusé. La concentration médiane de gentamicine du Groupe 1 (125,9 μg/ml) était supérieure à celle du Groupe 2 (82,7 μg/ml) et du Groupe 3 (56,1 μg/ml).(Traduit par Isabelle Vallières).
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Publication Date: 2013-10-02 PubMed ID: 24082163PubMed Central: PMC3595939
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  • Journal Article
  • Randomized Controlled Trial
  • Research Support
  • Non-U.S. Gov't

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study investigates how the volume of a perfusate, an intravenously injected fluid, influences the concentration of the antibiotic gentamicin in the synovial fluid in horse’s limbs. The research found that varying the volume did not significantly impact the antibiotic concentration, although the lowest volume had the highest concentration of gentamicin.

Study design and groups

In the study, the front limbs of 9 horses were used. These limbs were randomly divided into three groups, each with different volumes of perfusate. These were 10 mL (Group 1), 30 mL (Group 2), or 60 mL (Group 3).

  • A tourniquet was placed below the carpus (wrist of the horse) in each case.
  • Each limb was then perfused with gentamicin, an antibacterial medication, diluted to the assigned volume. This was done through a catheter placed in the lateral palmar digital vein near the proximal sesamoid bones (bones at the back of the limb, just above the hoof).

Data collection and analysis

To measure the concentration of gentamicin in the synovial fluid, the fluid found in the joints, samples were collected from the metacarpophalangeal joint (the joint between the metacarpal bone and the first phalanx, or digit) 30 minutes after perfusion.

  • After sample collection, the tourniquet was removed.
  • Gentamicin concentration in the synovial fluid samples was determined using a fluorescence polarization immunoassay, a method that relies on the property of polarization of fluorescent light to detect the amount of a specific substance in a sample.

Findings of the study

The study found no significant statistical differences in the antibiotic concentrations found in the synovial fluid among the three different perfusate volumes.

  • Interestingly, the group with the smallest volume of perfusate (Group 1 with 10 mL) had the highest concentration of gentamicin (125.9 μg/mL).
  • This was compared to the medium volume group (Group 2 with 30 mL) which had a lower concentration (82.7 μg/mL).
  • The lowest concentration was seen in the largest volume group (Group 3 with 60 mL), which measured 56.1 μg/mL.

This suggests that, in the specific case of intravenous regional limb perfusion, lower volumes may result in higher concentrations of the antibiotic in the synovial fluid. However, the lack of statistical significance means these results should be treated cautiously. Further studies with larger sample sizes may be needed to confirm these findings.

Cite This Article

APA
Hyde RM, Lynch TM, Clark CK, Slone DE, Hughes FE. (2013). The influence of perfusate volume on antimicrobial concentration in synovial fluid following intravenous regional limb perfusion in the standing horse. Can Vet J, 54(4), 363-367.

Publication

The Canadian veterinary journal = La revue veterinaire canadienne
ISSN: 0008-5286
NlmUniqueID: 0004653
Country: Canada
Language: English
Volume: 54
Issue: 4
Pages: 363-367

Researcher Affiliations

Hyde, Rosaleen M
  • Peterson and Smith Equine Hospital, 4747 SW 60th Avenue, Ocala, Florida 34474, USA.
Lynch, Timothy M
    Clark, Carol K
      Slone, Donnie E
        Hughes, Faith E

          MeSH Terms

          • Administration, Intravenous
          • Animals
          • Anti-Bacterial Agents / administration & dosage
          • Anti-Bacterial Agents / pharmacokinetics
          • Female
          • Forelimb
          • Gentamicins / administration & dosage
          • Gentamicins / pharmacokinetics
          • Horses
          • Perfusion / methods
          • Perfusion / veterinary
          • Synovial Fluid / chemistry
          • Tissue Distribution

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          Citations

          This article has been cited 7 times.
          1. Redding LE, Elzer EJ, Ortved KF. Effects of regional limb perfusion technique on concentrations of antibiotic achieved at the target site: A meta-analysis. PLoS One 2022;17(4):e0265971.
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          2. Vajs T, Nekouei O, Biermann NM. A Descriptive Study of the Clinical Presentation, Management, and Outcome of Horses with Acute Soft Tissue Trauma of the Tarsus and the Association with Synovial Involvement. Animals (Basel) 2022 Feb 21;12(4).
            doi: 10.3390/ani12040524pubmed: 35203232google scholar: lookup
          3. Bonilla AG, Causeret L, Torrent-Crosa A. Pharmacokinetics of ceftiofur in the metacarpophalangeal joint after standing intravenous regional limb perfusion in horses. Can Vet J 2021 Sep;62(9):975-981.
            pubmed: 34475583
          4. Mosichuk AP, Smith JS, Tatarniuk DM, Troy JR, Kreuder AJ. Meropenem Administered via Intravenous Regional Limb Perfusion for Orthopedic Sepsis in Horses: A Clinical Retrospective Study. Front Vet Sci 2021;8:629627.
            doi: 10.3389/fvets.2021.629627pubmed: 33842571google scholar: lookup
          5. Dahan R, Oreff GL, Tatz AJ, Raz T, Britzi M, Kelmer G. Pharmacokinetics of regional limb perfusion using a combination of amikacin and penicillin in standing horses. Can Vet J 2019 Mar;60(3):294-299.
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