Effects of volume replacement on plasma volume and albumin escape rate in a porcine model of fecal peritonitis

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Objectives

We investigated effects of 4% and 8% gelatin-based solutions, hydroxyethyl starch (HES) and ringer's solution on albumin escape rate (AER) and maintenance of plasma volume (PV) in a porcine fecal peritonitis model.

Design

This was a prospective randomized, controlled animal laboratory study.

Measurement and main results

Fasted, anaesthetized, mechanically ventilated and multi catheterized pigs (20.8± 1.8 kg) received 1 g of feces per kg of body weight into the abdominal cavity to induce sepsis and were observed over eight h. At induction, animals were randomized to resuscitation with gelatin 8% (n=5), gelatin 4% (n=5), 6% HES 200/0.5 (n=5), ringer's solution (n=5) and compared to a nonseptic control group (n=5) receiving 6% HES 200/0.5. The infusion rate was set to maintain a central venous pressure of 12 mmHg. Red blood cell volume was analyzed using chromium-51-tagged erythrocytes (RBC:⁵¹Cr). PV was determined from standard formulae. AER was calculated using 99m-labeled technetium serum albumin. Systemic hemodynamics and oxygenation were obtained before induction of sepsis, and 4 and 8 h afterwards.

Conclusion

PV was increased by gelatin 8% only. This suggests a better remaining volume in circulation during sepsis as there were no differences between infusion volume in all colloid groups. On the other hand, systemic oxygenation was significantly better in animals treated with HES than with gelatin 8% or 4%. In this respect, it is interesting to note that histological investigation of lung and kidney revealed a bluish blubbery fluid in small blood vessels, glomerula and tubules of the animals treated with gelatin 8% or gelatin 4%.

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