Pentoxifylline fails to improve organ dysfunction and survival when used in the resuscitation of a porcine model of haemorrhage and abdominal sepsis

Pentoxifylline is a phosphodiesterase inhibitor, known to suppress tumour n ecrosis factor-alpha production and improve cardiopulmonary parameters and survival in animal models of sepsis. Using a porcine model of abdominal tra uma resulting from the combined insults of haemorrhage and infection, a ran domised placebo-controlled trial was conducted of pentoxifylline (20 mg/kg bolus followed by 20 mg/kg infusion over 1 h) administered in addition to a colloid resuscitation regimen. Female Large White pigs (45-60 kg) were ble d 40% of their blood volume and peritonitis was induced using E. coli (O18: K1: H7) in an autoclaved faecal suspension. Animals were resuscitated with either colloid alone (n = 5) or colloid plus pentoxifylline (n = 5). Pento xifylline attenuated :increases in mean arterial and pulmonary artery press ures and reduced both systemic and pulmonary vascular resistance. It worsen ed the lactic acidosis associated with 'septic shock' and failed to reduce serum TNF-a levels. Pentoxifylline, in the high doses used in this study, d oes not have a role at; an adjunct to resuscitation in this clinically rele vant model of trauma. (C) 2000 Elsevier Science Ireland Ltd. All rights res erved.