Short-lasting systemic and regional benefits of early crystalloid infusion after intravenous inoculation of dogs with live Escherichia coli

Garrido, Arthur B.; Figueiredo, Luiz Francisco Poli de; Cruz, Ruy J.; Silva, E.; Silva, M. Rocha e

doi:10.1590/s0100-879x2005000600009

Cited by 19 publications

(33 citation statements)

References 34 publications

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“…Moreover, a brief period of hemodilution and flow improvement after fluid replacement suggest rapid extravascular redistribution of the infused fluid volume. These results were in accordance with our previous study (13). No changes were observed with enalaprilat infusion.…”

Section: Discussionsupporting

confidence: 94%

“…Such alterations may have resulted from a combination of arterial and venous vasodilatation, hypovolemia and myocardial depression. Bacterial-induced alterations in peripheral vascular tone, leading to venous pooling of blood and reduced venous return, probably accounted for the immediate decrease in systemic and splanchnic blood flow (13). The more modest decrease in MAP (~15%) in comparison to the greater decrease in blood flow could be attributed to a complex combination of vasoconstriction and vasodilatation.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, in an experimental model of hypodynamic septic shock induced by intravenous injection of live Escherichia coli, we found that the early crystalloid infusion resulted in partial and transient benefits, essentially during fluid infusion, which were especially poor in the splanchnic bed (13). These findings suggest significant early capillary leakage with extravascular redistribution of the crystalloid administered, and indicate that monitoring the gastrointestinal territory is probably desirable to improve splanchnic resuscitation.…”

Section: Introductionmentioning

confidence: 94%

“…Briefly, according to previous studies (13,14), the bacteria were stored in a preservation medium at room temperature, activated in trypticase soy broth, plated onto trypticase soy agar, and incubated at 37ºC for 24 h. Aliquots were then suspended in sterile saline. The bacterial suspension was estimated turbidimetrically by comparing the newly grown bacterial suspension to known standards by spectrophotometry at 625 nm, in order to obtain a culture of desired bacterial density.…”

Section: Bacterial Preparationmentioning

confidence: 99%

“…While fluid replacement has been considered essential to restore tissue oxygen transport and to prevent subsequent cardiovascular deterioration of severe sepsis to a septic shock state (1-3), the disparity between systemic and regional variables has been well demonstrated (6,8,(12)(13)(14). Recently, in an experimental model of hypodynamic septic shock induced by intravenous injection of live Escherichia coli, we found that the early crystalloid infusion resulted in partial and transient benefits, essentially during fluid infusion, which were especially poor in the splanchnic bed (13).…”

Section: Introductionmentioning

confidence: 99%

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Systemic and regional hemodynamic effects of enalaprilat infusion in experimental normotensive sepsis

Rahal¹,

Garrido²,

Cruz³

et al. 2006

Braz J Med Biol Res

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Angiotensin-converting enzyme inhibitors have been shown to improve splanchnic perfusion in distinct shock states. We hypothesized that enalaprilat potentiates the benefits of early fluid resuscitation in severe experimental sepsis, particularly in the splanchnic region. Anesthetized and mechanically ventilated mongrel dogs received an intravenous infusion of live Escherichia coli over a period of 30 min. Thereafter, two interventions were performed: fluid infusion (normal saline, 32 mL/kg over 30 min) and enalaprilat infusion (0.02 mg kg -1 min -1 for 60 min) in randomized groups. The following groups were studied: controls (fluid infusion, N = 4), E1 (enalaprilat infusion followed by fluid infusion, N = 5) and E2 (fluid infusion followed by enalaprilat infusion, N = 5). All animals were observed for a 120 min after bacterial infusion. Mean arterial pressure, cardiac output (CO), portal vein blood flow (PVBF), systemic and regional oxygen-derived variables, and lactate levels were measured. Rapid and progressive reductions in CO and PVBF were induced by the infusion of live bacteria, while minor changes were observed in mean arterial pressure. Systemic and regional territories showed a significant increase in oxygen extraction and lactate levels. Widening venous-arterial and portal-arterial pCO 2 gradients were also detected. Fluid replacement promoted transient benefits in CO and PVBF. Enalaprilat after fluid resuscitation did not affect systemic or regional hemodynamic variables. We conclude that in this model of normotensive sepsis inhibition of angiotensin-converting enzyme did not interfere with the course of systemic or regional hemodynamic and oxygen-derived variables.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Section: Bacterial Preparationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Systemic and regional hemodynamic effects of enalaprilat infusion in experimental normotensive sepsis

Rahal¹,

Garrido²,

Cruz³

et al. 2006

Braz J Med Biol Res

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Current Controversies in Sepsis Management

Moss

Prescott

2019

Semin Respir Crit Care Med

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The overarching goals of early sepsis management include early recognition, appropriate antibiotic therapy and source control, maintenance of hemodynamic stability, and supportive care of organ dysfunction. Despite increasing awareness of the global burden of sepsis, and general agreement on the goals of management, there is ongoing controversy regarding the implementation of specific treatment strategies to optimize patient outcomes. This article will address five current points of controversy in the management of sepsis and septic shock. These include optimal timing of antibiotics in patients with potential sepsis, the role of glucocorticoids in septic shock, vitamin C as a novel therapy for sepsis, the ideal intravenous fluid for resuscitation, and the optimal balance of fluid resuscitation and vasopressor administration in septic shock. For each of these topics, we review relevant literature, discuss areas of controversy, and present our current approach to management.

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Early Restoration of Cocaine-Induced Splanchnic Hypoperfusion in Anesthetized Dogs

Reis

Garrido

Cruz

et al. 2007

Journal of Investigative Surgery

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Although cardiovascular effects of cocaine have been well studied, little is known about its effects on splanchnic perfusion. We studied systemic and regional hemodynamic effects of acute cocaine intoxication in dogs under volatile anesthesia. Mechanically ventilated beagle dogs, randomized at 1.5% halothane (n = 7) or 2.25% sevoflurane (n = 7) anesthesia, received an intravenous bolus of cocaine (12 mg/kg over 5 min) followed by 0.22 mg/kg/min infusion over 30 min. They were observed for 60 min thereafter. Cardiac index (CI), heart rate (HR), mean arterial pressure (MAP), portal blood flow (PBF), gastric PCO(2) (gas tonometry), blood gases, and lactate and cocaine levels were assessed. Cocaine bolus promoted significant reductions in CI (~50%), HR (~20%), MAP (~20%), and PBF (~50%), accompanied by increase in systemic and splanchnic oxygen extractions and in gastric mucosal-arterial PCO(2) gradient. Those changes were maintained during cocaine infusion and returned to baseline values parallel to plasmatic cocaine clearance. Unlike other shock states, regional parameters, including gastric mucosal-arterial PCO(2) gradient, were restored before systemic variables. A possible local vasodilatory effect of volatile agents could play a role in this phenomenon. Cocaine infusion in anesthetized animals promoted marked systemic and regional hemodynamic derangement, which was rapidly reversible with decay of cocaine plasmatic concentration.

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Short-lasting systemic and regional benefits of early crystalloid infusion after intravenous inoculation of dogs with live Escherichia coli

Cited by 19 publications

References 34 publications

Systemic and regional hemodynamic effects of enalaprilat infusion in experimental normotensive sepsis

Systemic and regional hemodynamic effects of enalaprilat infusion in experimental normotensive sepsis

Current Controversies in Sepsis Management

Early Restoration of Cocaine-Induced Splanchnic Hypoperfusion in Anesthetized Dogs

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