Evaluation of renal perfusion by Doppler ultrasonography and the effect of Ulinastatin to it in a porcine model of septic shock

Abstract

Objective To develop a reliable and noninvasive method to evaluate the renal perfusion in a porcine model of septic shock and investigate the effect of UTI on it. Methods Thirty-two healthy male domestic pigs were randomly assigned to one of four groups: a sham group (SH, n=5); a septic shock group (SS, n=9); a septic shock group treated with vancomycin (15mg/kg) (VAN, n=9) and a septic shock group treated with UTI (50,000U/kg) + vancomycin (UTI, n= 9). Contrast-enhanced ultrasound (CEUS) of kidney at the baseline and the end of protocol (24h) were performed. The spectrum of interlobar or arcuate artery was selected to calculate the corrected resistive index (cRI). Sulphur hexafluoride (SF6) microbubbles were bolus injected via venous catheter. The peak intensity (Pi) and area under curve (AUC) were calculated by a time-intensity curve (TIC). Results cRI increased significantly at the end of the protocol except the SH groups, significant difference was found between each experimental group and the SH group. Linear regression was found between the cardiac output (CO) and Pi (Pi = 7.082 × CO + 5.026, R2=0.752, F=84.878, P < 0.001). The AUC decreased significantly post-injury in the SS and VAN group. All above parameters were improved by the UTI treatment, significant differences were found between the UTI and SS or VAN group respectively (P<0.05). Conclusions Septic shock occasionally accompanies with a significant low perfusion in renal microcirculation and UTI can improve it significantly.