Group B Streptococcus-induced acidosis in newborn swine: regional oxygen transport and lactate flux.
To investigate the mechanism of metabolic acidosis resulting from group B streptococcal sepsis, oxygen metabolism and lactate flux of the cerebrum, hindlimb, liver, splanchnic organs, and systemic vascular bed as a whole were examined. Nine 3- to 5-day-old awake and spontaneously breathing piglets were studied before and after 3, 4, and 5 h of continuous live group B Streptococcus infusion. After 5 h, oxygen delivery was decreased to all organs and to the whole systemic vascular bed. Increased oxygen extraction compensated for reduced oxygen delivery in the liver and splanchnic organs; however, it only partially offset reduced oxygen delivery to the hindlimb and systemic vascular bed. Cerebral oxygen extraction did not increase. As a result, oxygen uptake was reduced in the cerebrum, hindlimb, and systemic vascular bed. At 5 h of bacterial infusion, arterial lactate concentration was increased with regional lactate efflux from the cerebrum and hindlimb and influx to the liver (P less than 0.05 vs. zero or no net flux). We conclude that group B Streptococcus-induced metabolic acidosis is associated with regional lactate efflux from vascular beds in which oxygen uptake is reduced. We speculate that the quantity of net lactate efflux from vascular beds with insufficient oxygen uptake exceeds the net influx into organs such as the liver, resulting in metabolic acidosis.
Barefield
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ES
Department of Pediatrics, Brown University Program in Medicine, Women and Infants' Hospital of Rhode Island, Providence 02905.
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Stonestreet
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BS
D000138:Acidosis / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D000818:Animals; D000831:Animals, Newborn; D001693:Biological Transport, Active; D002302:Cardiac Output; D007773:Lactates / Q000378:metabolism; D019344:Lactic Acid; D010100:Oxygen / Q000378:metabolism; D012039:Regional Blood Flow; D012756:Sheep; D012772:Shock, Septic / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D013290:Streptococcal Infections / Q000378:metabolism* / Q000503:physiopathology; D013292:Streptococcus agalactiae
D007773:Lactates; D019344:Lactic Acid; D010100:Oxygen