Abstract 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. Design: A prospective study comparing 2 groups of septic pigs. Setting: A university animal research laboratory. Subjects: Eleven septic pigs. Interventions: 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. Conclusion: 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.Arch Surg. 1997;132:1111-1115 References 1. Baue AE. The horror autotoxicus and multiple-organ failure . Arch Surg . 1992; 127:1451-1462.Crossref 2. Prewitt RM, McCarthy J, Wood LDH. Treatment of acute low pressure pulmonary edema in dogs . J Clin Invest . 1981;67:409-418.Crossref 3. Gottlieb SS, Wood LDH, Hansen DE, Long R. The effect of introprusside on pulmonary edema, oxygen exchange, and blood flow in hydrochloric acid aspiration . Anesthesiology . 1987;67:203-210.Crossref 4. 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Archives of Surgery – American Medical Association
Published: Oct 1, 1997
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