title: Beneficial effects of ethyl pyruvate in septic shock from peritonitis.
abstract: OBJECTIVE
  Infusion of ethyl pyruvate (EP) solution can improve outcome in a clinically relevant, large- animal model of septic shock resulting from fecal peritonitis.
  
  
  METHODS
  Prospective randomized animal study.
  
  
  METHODS
  University hospital animal research laboratory.
  
  
  METHODS
  Fourteen female sheep.
  
  
  METHODS
  Fourteen fasted, anesthetized, invasively monitored, mechanically ventilated female sheep weighing (mean +/- SD) 30.4 +/- 3.8 kg received 0.5 g/kg of feces intraperitoneally to induce peritonitis, without administration of antibiotic agents or vasoactive drugs. After surgical preparation, the ewes were randomized to receive a continuous intravenous infusion at 15 mg/kg per hour of either EP combined with Ringer lactate solution or Ringer lactate solution only. Fluid resuscitation was titrated to maintain the pulmonary artery occlusion pressure at baseline levels throughout the experiment. All animals were monitored until they died spontaneously or for a maximum of 30 hours.
  
  
  RESULTS
  Compared with Ringer lactate solution alone, EP administration resulted in less tachycardia, longer time to development of arterial hypotension and oliguria (median, 27 vs 15 hours and 24 vs 16 hours, respectively; both P<.01), and prolonged survival time (median, 29.5 vs 17.0 hours; P<.001). Animals who received EP also had a smaller decrease in colloid osmotic pressure (P<.05) and a tendency for lower serum interleukin 6 concentrations (P = .08).
  
  
  CONCLUSIONS
  In this clinically relevant model of septic shock in ewes, continuous EP infusion prolonged time to development of organ dysfunction and markedly prolonged survival. These findings suggest a potential use for EP in the treatment of severe sepsis and septic shock.
authors.affiliation: Department of Intensive Care, Erasme University Hospital, Free University of Brussels, Brussels, Belgium.
authors.forename: Fuhong
authors.initials: F
authors.lastname: Su
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Cai
authors.forename: Myriam
authors.initials: M
authors.lastname: Remmelink
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D005421:Flavoring Agents; D005500:Follow-Up Studies; D007262:Infusions, Intravenous; D015850:Interleukin-6 / Q000097:blood; D010538:Peritonitis / Q000150:complications*; D011446:Prospective Studies; D011773:Pyruvates / Q000008:administration & dosage / Q000627:therapeutic use*; D012756:Sheep; D012772:Shock, Septic / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D005421:Flavoring Agents; D015850:Interleukin-6; D011773:Pyruvates; C046522:ethyl pyruvate