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Systemic and splanchnic hemodynamics, metabolism and PCO2-gap during septic shock induced by live E. coli infusion in dogs

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Background

The effects of intravenous live bacteria infusion on the time course of splanchnic oxygenation variables have not been adequately defined, as well as the effects of large volume crystalloid infusion on these variables.

Methods

Twenty-seven anesthetized mongrel dogs (17.1± 1.77 kg) were challenged by a 15 min intravenous infusion of live E. coli (6 × 109 CFU/kg) and followed for 90 min. The animals were then randomized in two groups over 60 min: CT (controls, n=13), no fluid infusion or LR (lactated Ringer's 32 ml/kg/h, n=14). Cardiac index (CI in l/min/m2), mean arterial pressure (MAP in mmHg), mesenteric blood flow (MBF in ml/min, ultrasonic flowprobe), oxygen-derived variables, lactate levels (in mmol/l) and gastric PCO2 (gastric tonometry in mmHg) were assessed throughout the 165 min experimental protocol. PCO2-gap was defined as the difference between gastric and arterial PCO2 and lactate flux was defined by the standard formula: ([portal lactate levels-arterial lactate levels]×MBF).

Results

Data are presented as mean ± SE. E.coli infusion significantly reduced MAP, CI, MBF, and increased PCO2-gap in both groups. Fluid infusion increased CI, systemic DO2 and stabilized PCO2-gap. Although MBF was similar in both groups, only controls presented gut lactate production. Table 1 shows the time course of MAP, CI, MBF, lactate flux and PCO2-gap of the two groups.

Conclusion

Although large-volume crystalloid infusion fails to restore mesenteric and gastric mucosal perfusion, it seems to prevent gut lactate production in a canine model of experimental septic shock.

Table 1 Time course of MAP, CI, MBF, Lactate Flux and PCO2-gap at baseline, 15, 105 and 165 min.

Acknowledgement

This study was suported by FAPESP, São Paulo, Brazil. Grants # 98/06458-7 and # 98/06459-3.

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Lagoa, C., Figueiredo, L., Cruz, R. et al. Systemic and splanchnic hemodynamics, metabolism and PCO2-gap during septic shock induced by live E. coli infusion in dogs. Crit Care 4, P153 (2000). https://doi.org/10.1186/cc873

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Keywords

  • Septic Shock
  • Gastric Tonometry
  • Mesenteric Blood Flow
  • Mucosal Perfusion
  • Crystalloid Infusion