Effect of iloprost on intestinal perfusion and energy balance in porcine hyperdynamic septic shock

Introduction: The prostacyclin analog Iloprost has been shown to improve sp lanchnic perfusion in endotoxin mediated septic shock. Aim of this study wa s to evaluate the therapeutic effect of Iloprost on splanchnic oxygen trans port and - utilization in a long-term model of septic shock in pigs. Methods: In a long term model of hyperdynamic porcine endotoxin shock (8 ng /kg min) th pCO(2) gap was determined by tonometry and indirect calorimetry was performed. Further macrohemodynamic monitoring and hepatic blood flow were assessed via a COLD catheter and doppler ultrsound flow probes on hepa tic artery and poral vein. Results and Conclusion: Treatment with the PGI(2) analogue Iloprost in a cl inically relevant dosage exerted no significant effect on intestinal perfus ion. However,Iloprost lead to an improved intestinal energy balance, as ind icated by the pCO(2)-gap. Furthermore, a significant improvement of the cyt osolic redox potential (lactat-pyruvate-ratio) was observed which could be interpreted as an improvement of intestinal oxygen supply.