HIGH-VOLUME VS STANDARD FLUID THERAPY IN A SEPTIC PIG MODEL - IMPACT ON PULMONARY-FUNCTION

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.