High-Volume vs Standard Fluid Therapy in a Septic Pig ModelImpact on Pulmonary Function
Mihae Yu, MD;
Nahidh W. Hasaniya, MD;
Danny M. Takanishi, MD;
Adriana Caldeira, MD;
Christiano C. B. Caldeira, MD;
Elizabeth Char, MD
Arch Surg. 1997;132(10):1111-1115.
Abstract
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Objective
To compare pulmonary function and peripheral organ blood flow in septic pigs receiving high-volume fluid resuscitation or standard-volume fluid resuscitation with similar goals in oxygen delivery.
Design
A prospective study comparing 2 groups of septic pigs.
Setting
A university animal research laboratory.
Subjects
Eleven septic pigs.
Interventions
Basal oxygen delivery was increased from 450 to 550 mL/min to at least 600 mL/min by the sixth hour and maintained for 24 hours. From a baseline pulmonary artery occlusion pressure (PAOP) measurement of approximately 6 mm Hg, the high-volume group (n=5) was treated until a PAOP measurement of 12 mm Hg was reached and the standard-volume group (n=6) was treated until a PAOP measurement of 8 mm Hg was reached. Blood transfusions and inotropic agents were added as necessary to reach the oxygen delivery goal.
Results
The high-volume group had 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
Resuscitation with large volumes of fluid in early sepsis with a physiological goal of a higher PAOP to augment oxygen delivery did not cause increased pulmonary edema and oxygenation deficit compared with maintenance of lower cardiac filling pressures.
Arch Surg. 1997;132:1111-1115
Author Affiliations
From the Department of Surgery, Division of Surgical Critical Care, University of Hawaii, Honolulu (Drs Yu, Hasaniya, Takanishi, A. Caldeira, C. C. B. Caldeira, and Char); and The Queen's Medical Center, Honolulu (Dr Yu).
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