M. Yu et al., HIGH-VOLUME VS STANDARD FLUID THERAPY IN A SEPTIC PIG MODEL - IMPACT ON PULMONARY-FUNCTION, Archives of surgery, 132(10), 1997, pp. 1111-1115
Objective: To compare pulmonary function and peripheral organ blood fl
ow in septic pigs receiving high-volume fluid resuscitation or standar
d-volume fluid resuscitation with similar goals in oxygen delivery. De
sign: A prospective study comparing 2 groups of septic pigs. Setting:
A university animal research laboratory. Subjects: Eleven septic pigs.
Interventions: Basal oxygen delivery tvas increased from 450 to 550 m
L/min to at least 600 mL/min by the sixth hour and maintained for 24 h
ours. From a baseline pulmonary artery occlusion pressure (PAOP) measu
rement of approximately 6 mm Hg, the high-volume group (n=5) was treat
ed until a PAOP measurement of 12 mm Hg was reached and the standard-v
olume group (n=6) was treated until a PAOP measurement of 8 mm Hg was
reached. Blood transfusions and inotropic agents were added as necessa
ry to reach the oxygen delivery goal. Results: The high-volume group h
ad a significantly greater positive fluid balance, greater weight gain
, and a higher PAOP but similar intrapulmonary shunt and extravascular
lung water as compared with the standard-volume group. Conclusion: Re
suscitation with large volumes of fluid in early sepsis with a physiol
ogical goal of a higher PAOP to augment oxygen delivery did not cause
increased pulmonary edema and oxygenation deficit compared with mainte
nance of lower cardiac filling pressures.