[Effect of hydroxyethyl starch and Ringer's solution on splanchnic perfusion in dogs with septic shock].

ABSTRACT

OBJECTIVE: To investigate the effect of 6% hydroxyethyl starch (HES) and Ringer's solution (RS) on splanchnic perfusion in dogs with septic shock. METHODS: Twenty-four mongrel dogs with septic shock induced by lipopolysaccharides (LPS) were randomly divided into two groups HES group and RS group. Dogs of each group received an intravenous infusion of HES or RS (1 mlxkg(-1)xmin(-1)) for 60 minutes, followed by normal saline for 180 minutes with same infusion speed. Parameters of hemodynamics, oxygen dynamic, and splanchnic perfusion were monitored at 0, 30, 60, 120, 180, 240 minutes after basic measurements (pre-LPS). RESULTS: (1) After LPS infusion, mean arterial pressure (MAP) and cardiac index (CI) lowered significantly (P<0.05). Compared to that of 0 minutes, MAP and CI were elevated by fluid therapy in both groups, but there was no difference between HES and RS group. (2) Compared with pre-LPS, oxygen delivery (DO(2)) was reduced, arterial blood pH lowered and arterial lactate level increased markedly at 0 minutes (P<0.05). DO(2) increased by fluid therapy in both groups, but DO(2) was higher in HES group at the same time points (P<0.05). Compared to 0 minutes, arterial lactate levels were lowered at 180 minutes in both groups. (3) Mesenteric blood flow decreased after LPS infusion in all animals (P<0.05). Mesenteric blood flow increased after HES infusion, at the same time intramucosal pH (pHi) was elevated and Pg-aCO(2) decreased significantly (all P<0.05), but they showed no difference in RS group. At the same time, mesenteric blood flow and pHi was higher in HES group than that in RS group. CONCLUSION: Both HES and RS could improve MAP and DO(2) in dogs with septic shock, but the effect of HES was better than RS on splanchnic perfusion.