High-volume vs standard fluid therapy in a septic pig model. Impact on pulmonary function.
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.


METHODS
A prospective study comparing 2 groups of septic pigs.


METHODS
A university animal research laboratory.


METHODS
Eleven septic pigs.


METHODS
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.


CONCLUSIONS
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.
Yu
M
M
Department of Surgery, University of Hawaii, Honolulu, USA.
Hasaniya
N W
NW
Takanishi
D M
DM
Caldeira
A
A
Caldeira
C C
CC
Char
E
E
D000818:Animals; D005440:Fluid Therapy / Q000379:methods*; D008168:Lung / Q000503:physiopathology*; D018805:Sepsis / Q000503:physiopathology / Q000628:therapy*; D013552:Swine