This article is part of the supplement: Fourth International Symposium on Intensive Care and Emergency Medicine for Latin America
Early fluid replacement with hypertonic isoncotic solution guided by mixed venous oxygen saturation in experimental hypodynamic sepsis
LIM 11, InCor, University of São Paulo School of Medicine, São Paulo – SP, Brazil
Critical Care 2007, 11(Suppl 3):P10 doi:10.1186/cc5797
The electronic version of this article is the complete one and can be found online at: http://ccforum.com/content/11/S3/P10
| Published: | 19 June 2007 |
© 2007 BioMed Central Ltd
Introduction
Volume replacement is one of the cornerstones in the management of sepsis. The type and amount of fluid are still controversial.
Hypothesis
A hypertonic isoncotic solution could promote superior hemodynamic benefits as the initial fluid regimen than standard crystalloid resuscitation, and mixed venous oxygen saturation could be useful to guide fluid administration in experimental sepsis.
Methods
Anesthetized mongrel dogs received an intravenous infusion of 1.2 × 1010 cfu/kg live E. coli in 30 minutes (T0–T30). After 60 minutes (T90), the dogs were randomized to receive isotonic saline solution, 32 ml/kg over 20 minutes (NS, n = 7) or 7.5% hypertonic isoncotic solution (Hyper-Haes) 4 ml/kg over 5 minutes (HH, n = 7). After 30 and 60 minutes (T120 and T150), additional isotonic saline solution 32 ml/kg was administered if mixed venous oxygen saturation was below 70% in both groups. the mean arterial pressure (MAP), cardiac output (CO) and portal blood flow (PVBF) were monitored; blood gases and lactate levels were analyzed at each timepoint.
Results
See Table 1. Data are expressed as the mean ± SEM.
Conclusion
Both solutions promoted similar and partial benefits at systemic and regional levels in this hypodynamic sepsis model. Although initial fluid requirement after HH was lower than NS, overall fluid infused was not statistically different between groups (HH 31.4 ± 10.9 ml/kg vs NS 50.3 ± 6.5 ml/kg).
Acknowledgements
Supported by FAPESP 05/51176-5.