Beneficial effects of hypertonic saline/dextran on early survival in porcine endotoxin shock.
Acta Anaesthesiol Scand
; 49(8): 1124-34, 2005 Sep.
Article
de En
| MEDLINE
| ID: mdl-16095454
ABSTRACT
BACKGROUND:
Hypertonic saline/dextran (HSD) has been shown to have beneficial effects in haemorrhagic shock. These effects, with improved haemodynamics and organ perfusion, would in theory also be of benefit in septic shock. However, this is less studied. We have therefore further evaluated the effect of additional treatment with HSD in a porcine endotoxin shock model.METHODS:
Sixteen anaesthetized pigs were used. A continuous infusion of endotoxin (LPS EC) was increased stepwise during 30 min to a rate of 5 microg/kg/h. The infusion was discontinued after 3 h and the animals were observed for another 2 h. The animals received continuous basal fluid resuscitation with isotonic Ringer's glucose 2.5% at a rate of 20 ml/kg/h throughout the experiment. After 1 h of endotoxin infusion, the animals were randomized to additional treatment with HSD, 4 ml/kg over 5 min, or the same volume of isotonic saline. Every 30 min, haemodynamics and mixed venous saturation (SvO2) were measured via a pulmonary artery catheter. Regional blood flow rates were measured continuously by perivascular ultrasonic flow probes. The metabolic response was measured by arterial blood gas analysis.RESULTS:
The endotoxin put all animals into a progressive hypodynamic circulatory shock during the experiment. Treatment with HSD improved survival rate to 8/8 compared with controls 3/8. There was a transient circulatory recovery with improved central and regional haemodynamics, accompanied by stabilized metabolic response.CONCLUSION:
Treatment with additional HSD improves survival in an early phase of endotoxin shock. Generally improved haemodynamics and oxygenation of peripheral tissues are suggested as possible mechanisms.
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Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Solution saline hypertonique
/
Choc septique
/
Dextrane
/
Anticoagulants
Type d'étude:
Prognostic_studies
Limites:
Animals
Langue:
En
Journal:
Acta Anaesthesiol Scand
Année:
2005
Type de document:
Article
Pays d'affiliation:
Suède