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Original Article - Basic Research01-31-2012
Volume replacement with saline solutions during pancreatitis in rats and the hepatic profiles of apoptotic proteins and heat-shock proteins
Revista Brasileira de Terapia Intensiva. 2012;24(4):326-333
Abstract
Original Article - Basic ResearchVolume replacement with saline solutions during pancreatitis in rats and the hepatic profiles of apoptotic proteins and heat-shock proteins
Revista Brasileira de Terapia Intensiva. 2012;24(4):326-333
DOI 10.1590/S0103-507X2012000400006
Views46See moreOBJECTIVE: Liver failure can occur as a consequence of the systemic inflammation after acute pancreatitis. We assessed the effect of volume repositioning with hypertonic saline solution or normal saline on hepatic cytokine production and the expression of heat-shock proteins and apoptotic proteins after acute pancreatitis. METHODS: Wistar rats were divided in four groups: C - control animals that were not subjected to insult or treatment; NT - animals that were subjected to acute pancreatitis and received no treatment; normal saline - animals that were subjected to acute pancreatitis and received normal saline (NaCl 0.9%); and HS - animals that were subjected to acute pancreatitis and received hypertonic saline solution (NaCl 7.5%). Acute pancreatitis was induced by retrograde transduodenal infusion of 2.5% sodium taurocholate into the pancreatic duct. At 4, 12 and 24 h following acute pancreatitis induction, TNF-alpha, IL-1-beta, IL-6 and IL-10, caspase-2 and -7, Apaf-1, AIF and HSP60 and 90 were analyzed in the liver. RESULTS: Casp2 decreased in the normal saline and hypertonic saline groups (p<0.05 versus. C) at 12 h. Apaf-1, AIF and HSP90 remained unchanged. At 4 h, Casp7 increased in the NT group (p<0.01 versus C), although it remained at the baseline levels in the reperfused groups. HSP60 increased in all of the groups at 4 h (p< 0.001 vs. C). However, the hypertonic saline group showed lower expression of HSP60 than the normal saline group (p<0.05). Hypertonic saline solution maintained the production of cytokines at normal levels. Volume reperfusion with normal or hypertonic saline significantly modulated the expression of Casp7. CONCLUSION: Volume replacement with hypertonic or normal saline was effective in reducing caspase 7. However, only hypertonic solution was capable of regulating cytokine production and HSP60 expression at all time points.
Views46
Abstract
Original Article - Basic ResearchVolume replacement with saline solutions during pancreatitis in rats and the hepatic profiles of apoptotic proteins and heat-shock proteins
Revista Brasileira de Terapia Intensiva. 2012;24(4):326-333
DOI 10.1590/S0103-507X2012000400006
Views46See moreOBJECTIVE: Liver failure can occur as a consequence of the systemic inflammation after acute pancreatitis. We assessed the effect of volume repositioning with hypertonic saline solution or normal saline on hepatic cytokine production and the expression of heat-shock proteins and apoptotic proteins after acute pancreatitis. METHODS: Wistar rats were divided in four groups: C - control animals that were not subjected to insult or treatment; NT - animals that were subjected to acute pancreatitis and received no treatment; normal saline - animals that were subjected to acute pancreatitis and received normal saline (NaCl 0.9%); and HS - animals that were subjected to acute pancreatitis and received hypertonic saline solution (NaCl 7.5%). Acute pancreatitis was induced by retrograde transduodenal infusion of 2.5% sodium taurocholate into the pancreatic duct. At 4, 12 and 24 h following acute pancreatitis induction, TNF-alpha, IL-1-beta, IL-6 and IL-10, caspase-2 and -7, Apaf-1, AIF and HSP60 and 90 were analyzed in the liver. RESULTS: Casp2 decreased in the normal saline and hypertonic saline groups (p<0.05 versus. C) at 12 h. Apaf-1, AIF and HSP90 remained unchanged. At 4 h, Casp7 increased in the NT group (p<0.01 versus C), although it remained at the baseline levels in the reperfused groups. HSP60 increased in all of the groups at 4 h (p< 0.001 vs. C). However, the hypertonic saline group showed lower expression of HSP60 than the normal saline group (p<0.05). Hypertonic saline solution maintained the production of cytokines at normal levels. Volume reperfusion with normal or hypertonic saline significantly modulated the expression of Casp7. CONCLUSION: Volume replacement with hypertonic or normal saline was effective in reducing caspase 7. However, only hypertonic solution was capable of regulating cytokine production and HSP60 expression at all time points.
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Original Article - Basic Research11-05-2012
N-acetylcysteine and deferrioxamine protects against acute renal failure induced by ischemia/reperfusion in rats
Revista Brasileira de Terapia Intensiva. 2012;24(3):219-223
Abstract
Original Article - Basic ResearchN-acetylcysteine and deferrioxamine protects against acute renal failure induced by ischemia/reperfusion in rats
Revista Brasileira de Terapia Intensiva. 2012;24(3):219-223
DOI 10.1590/S0103-507X2012000300003
Views70See moreOBJECTIVE: Antioxidants are widely used in animal models to prevent renal injury after ischemia/reperfusion, but it is unknown if the benefits of antioxidants are additive. In this study, we aimed to investigate the protective effects of N-acetylcysteine plus deferoxamine in an animal model of kidney ischemia/reperfusion injury. METHODS: Bilateral kidney ischemia was mastintained for 45 minutes. N-acetylcysteine, deferoxamine or both were administered into the aorta above the renal arteries immediately prior to induction of ischemia. Five rats from each group were sacrificed 1, 6 or 12 hours after reperfusion for the determination of blood creatinine, kidney oxidative damage parameters and myeloperoxidase activity. RESULTS: The combination of N-acetylcysteine and deferoxamine, but not their isolated use, prevented the increase in creatinine after ischemia/reperfusion. This prevention was followed by a consistent decrease in myeloperoxidase activity and oxidative damage parameters both in the kidney cortex and medulla. CONCLUSION: Treatment with N-acetylcysteine and deferoxamine was superior to the isolated use of either compound in an animal model of kidney ischemia/reperfusion.
Views70Abstract
Original Article - Basic ResearchN-acetylcysteine and deferrioxamine protects against acute renal failure induced by ischemia/reperfusion in rats
Revista Brasileira de Terapia Intensiva. 2012;24(3):219-223
DOI 10.1590/S0103-507X2012000300003
Views70See moreOBJECTIVE: Antioxidants are widely used in animal models to prevent renal injury after ischemia/reperfusion, but it is unknown if the benefits of antioxidants are additive. In this study, we aimed to investigate the protective effects of N-acetylcysteine plus deferoxamine in an animal model of kidney ischemia/reperfusion injury. METHODS: Bilateral kidney ischemia was mastintained for 45 minutes. N-acetylcysteine, deferoxamine or both were administered into the aorta above the renal arteries immediately prior to induction of ischemia. Five rats from each group were sacrificed 1, 6 or 12 hours after reperfusion for the determination of blood creatinine, kidney oxidative damage parameters and myeloperoxidase activity. RESULTS: The combination of N-acetylcysteine and deferoxamine, but not their isolated use, prevented the increase in creatinine after ischemia/reperfusion. This prevention was followed by a consistent decrease in myeloperoxidase activity and oxidative damage parameters both in the kidney cortex and medulla. CONCLUSION: Treatment with N-acetylcysteine and deferoxamine was superior to the isolated use of either compound in an animal model of kidney ischemia/reperfusion.
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Original Article - Basic Research08-01-2012
Interleukin-12 in children with sepsis and septic shock
Revista Brasileira de Terapia Intensiva. 2012;24(2):130-136
Abstract
Original Article - Basic ResearchInterleukin-12 in children with sepsis and septic shock
Revista Brasileira de Terapia Intensiva. 2012;24(2):130-136
DOI 10.1590/S0103-507X2012000200006
Views46See moreOBJECTIVE: To examine the behavior of interleukin-12 and verify whether it can be used to differentiate septic conditions in children. METHODS: Septic children aged between 28 days and 14 years, prospectively enrolled from 01/2004 to 12/2005, were divided into sepsis (SG; n=47) and septic shock (SSG; n=43) groups. Interleukin-12 levels were measured at admission (T0) and 12 hours later (T12). Disease severity was assessed by the PRISM score. RESULTS: Interleukin-12 levels did not differentiate children with sepsis from those with septic shock at admission [SSG: 0.24 (0-226.4)=SG: 1.23 (0-511.6); p=0.135)] and T12 [SG: 6.11 (0-230.5)=SSG: 1.32 (0-61.0); p=0.1239)]. Comparing time points, no significant difference was observed in the SG [SG, T0: 1.23 (0-511.6)=T12: 6.11 (0-230.5); p=0.075]. In SSG however, interleukin-12 increased from T0 to T12 (SSG, T0: 0.24 (0-226.4)
Views46Abstract
Original Article - Basic ResearchInterleukin-12 in children with sepsis and septic shock
Revista Brasileira de Terapia Intensiva. 2012;24(2):130-136
DOI 10.1590/S0103-507X2012000200006
Views46See moreOBJECTIVE: To examine the behavior of interleukin-12 and verify whether it can be used to differentiate septic conditions in children. METHODS: Septic children aged between 28 days and 14 years, prospectively enrolled from 01/2004 to 12/2005, were divided into sepsis (SG; n=47) and septic shock (SSG; n=43) groups. Interleukin-12 levels were measured at admission (T0) and 12 hours later (T12). Disease severity was assessed by the PRISM score. RESULTS: Interleukin-12 levels did not differentiate children with sepsis from those with septic shock at admission [SSG: 0.24 (0-226.4)=SG: 1.23 (0-511.6); p=0.135)] and T12 [SG: 6.11 (0-230.5)=SSG: 1.32 (0-61.0); p=0.1239)]. Comparing time points, no significant difference was observed in the SG [SG, T0: 1.23 (0-511.6)=T12: 6.11 (0-230.5); p=0.075]. In SSG however, interleukin-12 increased from T0 to T12 (SSG, T0: 0.24 (0-226.4)
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Original Article - Basic Research08-01-2012
Acute hemodynamic, respiratory and metabolic alterations after blood contact with a volume priming and extracorporeal life support circuit: an experimental study
Revista Brasileira de Terapia Intensiva. 2012;24(2):137-142
Abstract
Original Article - Basic ResearchAcute hemodynamic, respiratory and metabolic alterations after blood contact with a volume priming and extracorporeal life support circuit: an experimental study
Revista Brasileira de Terapia Intensiva. 2012;24(2):137-142
DOI 10.1590/S0103-507X2012000200007
Views49OBJECTIVE: To investigate the hemodynamic, respiratory and metabolic impact of blood contact with a priming volume and extracorporeal membrane oxygenation circuit, before the initiation of oxygenation and ventilation METHODS: Five animals were instrumented and submitted to extracorporeal membrane oxygenation. Data were collected at the baseline and 30 minutes after starting extracorporeal circulation, without membrane ventilatory (sweeper) flow. RESULTS: After starting extracorporeal membrane oxygenation, there was a non-significant elevation in pulmonary vascular resistance from 235 (178,303) to 379 (353,508) dyn.seg.(cm5)-1 (P=0.065), associated with an elevation in the alveolar arterial oxygen gradient from 235 (178,303) to 379 (353,508) mmHg (P=0.063). We also observed a reduction in the left ventricle stroke work from 102 (94,105) to 78 (71,87) (mL.mmHg)/beat (P=0.064), in addition to a reduction in cardiac output from 7.2 (6.8,7.6) to 5.9 (5.8,6.3) L/min (P=0.188). The right ventricle stroke work was counterbalanced between the pulmonary vascular resistance increment and the cardiac output reduction, maintaining a similar value. CONCLUSIONS: We presented an experimental model that is feasible and safe. Blood contact with the priming volume and extracorporeal membrane oxygenation circuit resulted in non-significant systemic or metabolic changes.
Keywords:acute respiratory distress syndromeExtracorporeal membrane oxygenationMultiple organ failureRespiration, artificialSwineSee moreViews49Abstract
Original Article - Basic ResearchAcute hemodynamic, respiratory and metabolic alterations after blood contact with a volume priming and extracorporeal life support circuit: an experimental study
Revista Brasileira de Terapia Intensiva. 2012;24(2):137-142
DOI 10.1590/S0103-507X2012000200007
Views49OBJECTIVE: To investigate the hemodynamic, respiratory and metabolic impact of blood contact with a priming volume and extracorporeal membrane oxygenation circuit, before the initiation of oxygenation and ventilation METHODS: Five animals were instrumented and submitted to extracorporeal membrane oxygenation. Data were collected at the baseline and 30 minutes after starting extracorporeal circulation, without membrane ventilatory (sweeper) flow. RESULTS: After starting extracorporeal membrane oxygenation, there was a non-significant elevation in pulmonary vascular resistance from 235 (178,303) to 379 (353,508) dyn.seg.(cm5)-1 (P=0.065), associated with an elevation in the alveolar arterial oxygen gradient from 235 (178,303) to 379 (353,508) mmHg (P=0.063). We also observed a reduction in the left ventricle stroke work from 102 (94,105) to 78 (71,87) (mL.mmHg)/beat (P=0.064), in addition to a reduction in cardiac output from 7.2 (6.8,7.6) to 5.9 (5.8,6.3) L/min (P=0.188). The right ventricle stroke work was counterbalanced between the pulmonary vascular resistance increment and the cardiac output reduction, maintaining a similar value. CONCLUSIONS: We presented an experimental model that is feasible and safe. Blood contact with the priming volume and extracorporeal membrane oxygenation circuit resulted in non-significant systemic or metabolic changes.
Keywords:acute respiratory distress syndromeExtracorporeal membrane oxygenationMultiple organ failureRespiration, artificialSwineSee more
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Original Article - Basic Research04-24-2012
The effects of mechanical ventilation on oxidative stress
Revista Brasileira de Terapia Intensiva. 2012;24(1):23-29
Abstract
Original Article - Basic ResearchThe effects of mechanical ventilation on oxidative stress
Revista Brasileira de Terapia Intensiva. 2012;24(1):23-29
DOI 10.1590/S0103-507X2012000100004
Views71OBJECTIVE: Mechanical ventilation is a mainstay of therapy in intensive care units; however, its deleterious effects need to be assessed. Therefore, we aimed to assess oxidative stress in patients admitted to an intensive care unit undergoing invasive mechanical ventilation. METHODS: This cross-sectional study included 12 invasive mechanical ventilation patients. Blood samples (3 mL) were collected on the first and last days on invasive mechanical ventilation. Thiobarbituric acid-reacting substances (TBARS) were assessed in plasma, and superoxide dismutase (SOD) and catalase (CAT) were assessed in erythrocytes. RESULTS: The mean age was 64.8 ± 17.6 years, the tidal volume (VT) 382 ± 44.5 mL, and the APACHE II score 15 ± 7. When initial and final TBARS were compared, a significant difference was identified (3.54 ± 0.74 vs. 4.96 ± 1.47, p = 0.04). Antioxidant enzymes showed no significant differences. Correlations between PaO2/FiO2 and TBARS (r = 0.4), SOD and PaO2/FiO2 (r = 0.51) and APACHE II and SOD (r = 0.56) were identified. Six patients died. CONCLUSION: Patients undergoing invasive mechanical ventilation can develop redox state changes, showing increased TBARS and reduced antioxidant enzymes.
Keywords:intensive care unitsOxidative stressRespiration, artificialThiobarbituric acid reactive substancesSee moreViews71Abstract
Original Article - Basic ResearchThe effects of mechanical ventilation on oxidative stress
Revista Brasileira de Terapia Intensiva. 2012;24(1):23-29
DOI 10.1590/S0103-507X2012000100004
Views71OBJECTIVE: Mechanical ventilation is a mainstay of therapy in intensive care units; however, its deleterious effects need to be assessed. Therefore, we aimed to assess oxidative stress in patients admitted to an intensive care unit undergoing invasive mechanical ventilation. METHODS: This cross-sectional study included 12 invasive mechanical ventilation patients. Blood samples (3 mL) were collected on the first and last days on invasive mechanical ventilation. Thiobarbituric acid-reacting substances (TBARS) were assessed in plasma, and superoxide dismutase (SOD) and catalase (CAT) were assessed in erythrocytes. RESULTS: The mean age was 64.8 ± 17.6 years, the tidal volume (VT) 382 ± 44.5 mL, and the APACHE II score 15 ± 7. When initial and final TBARS were compared, a significant difference was identified (3.54 ± 0.74 vs. 4.96 ± 1.47, p = 0.04). Antioxidant enzymes showed no significant differences. Correlations between PaO2/FiO2 and TBARS (r = 0.4), SOD and PaO2/FiO2 (r = 0.51) and APACHE II and SOD (r = 0.56) were identified. Six patients died. CONCLUSION: Patients undergoing invasive mechanical ventilation can develop redox state changes, showing increased TBARS and reduced antioxidant enzymes.
Keywords:intensive care unitsOxidative stressRespiration, artificialThiobarbituric acid reactive substancesSee more
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Original Article - Basic Research04-24-2012
Inflammatory and oxidative cord blood parameters as predictors of neonatal sepsis severity
Revista Brasileira de Terapia Intensiva. 2012;24(1):30-34
Abstract
Original Article - Basic ResearchInflammatory and oxidative cord blood parameters as predictors of neonatal sepsis severity
Revista Brasileira de Terapia Intensiva. 2012;24(1):30-34
DOI 10.1590/S0103-507X2012000100005
Views59OBJECTIVES: Neonatal sepsis is a complex syndrome involving an uncontrolled systemic inflammatory response associated with an infection. It may result in the dysfunction or failure of one or more organs or even death. Given its high incidence in premature neonates, the identification of prognostic factors to optimize the early diagnosis and therapeutic interventions are highly desirable. This objective study determine the relationship between inflammatory markers and oxidative parameters as prognostic factors in early neonatal sepsis. METHODS: We conducted a prospective observational study by collecting data from 120 patients in the maternity unit of a university hospital. Preterm (<37 weeks of pregnancy) infants with at least one additional risk factor for neonatal sepsis were included. The levels of interleukin (IL)-6, IL-10, thiobarbituric acid reactive species (TBARS) and protein carbonyls and their association with sepsis severity were determined in the cord blood. RESULTS: Levels of IL-6 and TBARS, but not IL-10 and protein carbonyls, demonstrated a mild to moderate correlation with the SNAPPE-II severity score (r=0.435, p=0.02 and r = 0.385, p = 0.017, respectively). No correlations were found between these markers and mortality. CONCLUSION: TBARS and IL-6 have a mild to moderate correlation with SNAPPE-II, but none of the studied markers were able to predict mortality in our sample.
Keywords:Fetal bloodInfant, newbornIntensive care units, neonatalInterleukin-10Interleukin-6Oxidative stresssepsisSee moreViews59Abstract
Original Article - Basic ResearchInflammatory and oxidative cord blood parameters as predictors of neonatal sepsis severity
Revista Brasileira de Terapia Intensiva. 2012;24(1):30-34
DOI 10.1590/S0103-507X2012000100005
Views59OBJECTIVES: Neonatal sepsis is a complex syndrome involving an uncontrolled systemic inflammatory response associated with an infection. It may result in the dysfunction or failure of one or more organs or even death. Given its high incidence in premature neonates, the identification of prognostic factors to optimize the early diagnosis and therapeutic interventions are highly desirable. This objective study determine the relationship between inflammatory markers and oxidative parameters as prognostic factors in early neonatal sepsis. METHODS: We conducted a prospective observational study by collecting data from 120 patients in the maternity unit of a university hospital. Preterm (<37 weeks of pregnancy) infants with at least one additional risk factor for neonatal sepsis were included. The levels of interleukin (IL)-6, IL-10, thiobarbituric acid reactive species (TBARS) and protein carbonyls and their association with sepsis severity were determined in the cord blood. RESULTS: Levels of IL-6 and TBARS, but not IL-10 and protein carbonyls, demonstrated a mild to moderate correlation with the SNAPPE-II severity score (r=0.435, p=0.02 and r = 0.385, p = 0.017, respectively). No correlations were found between these markers and mortality. CONCLUSION: TBARS and IL-6 have a mild to moderate correlation with SNAPPE-II, but none of the studied markers were able to predict mortality in our sample.
Keywords:Fetal bloodInfant, newbornIntensive care units, neonatalInterleukin-10Interleukin-6Oxidative stresssepsisSee more
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Original Article - Basic Research04-04-2011
Association between organ dysfunction and cytokine concentrations during the early phases of septic shock
Revista Brasileira de Terapia Intensiva. 2011;23(4):426-433
Abstract
Original Article - Basic ResearchAssociation between organ dysfunction and cytokine concentrations during the early phases of septic shock
Revista Brasileira de Terapia Intensiva. 2011;23(4):426-433
DOI 10.1590/S0103-507X2011000400006
Views54OBJECTIVE: To investigate the correlation of organ dysfunction and its progression with inflammatory response during the early phases of septic shock by assessing baseline cytokine concentrations. METHODS: This study included patients over 18 years old with septic shock within the first 48 hours after the onset of organ dysfunction. Interleukin 6 (IL-6), interleukin 8 (IL-8), interleukin 10 (IL-10) and C-reactive protein levels were assessed at inclusion and after 24 hours, and the differences between these values were calculated. The progression of organ dysfunction was assessed using the Sequential Organ Failure Assessment (SOFA) score upon admission and 24 hours later for a delta-SOFA determination and were categorized as either worsened or improved. The results were expressed as means + standard deviation or median (25-75% percentiles). Values with descriptive p values of 0.05 or less were considered significant. RESULTS: Overall, we included 41 patients with median SOFA scores of 8.0 (6.5-10.0) upon admission (T0) and 8.0 (6.0-10.0) 24 hours later (T1). Worsened, improved or unchanged SOFA scores were observed in 11 (Group 1), 17 (Group 2) and 13 (Group 3) patients, respectively. For Group 1, the baseline IL-6, IL-8 and IL-10 values were higher, and a significant increase of IL-8 levels was found after 24 hours. The change in the SOFA score after 24 hours was significantly, although weakly, correlated with baseline IL-6 and IL-8 concentrations. CONCLUSIONS: Higher baseline IL-6, IL-8 and IL-10 levels are associated with unfavorable organ dysfunction outcomes. Increased IL-8 levels within the first 24 hours are correlated with a worsening dysfunction.
Keywords:CytokinesetiologyMultiple organ failureShock, septicsystemic inflammatory response syndromeSee moreViews54Abstract
Original Article - Basic ResearchAssociation between organ dysfunction and cytokine concentrations during the early phases of septic shock
Revista Brasileira de Terapia Intensiva. 2011;23(4):426-433
DOI 10.1590/S0103-507X2011000400006
Views54OBJECTIVE: To investigate the correlation of organ dysfunction and its progression with inflammatory response during the early phases of septic shock by assessing baseline cytokine concentrations. METHODS: This study included patients over 18 years old with septic shock within the first 48 hours after the onset of organ dysfunction. Interleukin 6 (IL-6), interleukin 8 (IL-8), interleukin 10 (IL-10) and C-reactive protein levels were assessed at inclusion and after 24 hours, and the differences between these values were calculated. The progression of organ dysfunction was assessed using the Sequential Organ Failure Assessment (SOFA) score upon admission and 24 hours later for a delta-SOFA determination and were categorized as either worsened or improved. The results were expressed as means + standard deviation or median (25-75% percentiles). Values with descriptive p values of 0.05 or less were considered significant. RESULTS: Overall, we included 41 patients with median SOFA scores of 8.0 (6.5-10.0) upon admission (T0) and 8.0 (6.0-10.0) 24 hours later (T1). Worsened, improved or unchanged SOFA scores were observed in 11 (Group 1), 17 (Group 2) and 13 (Group 3) patients, respectively. For Group 1, the baseline IL-6, IL-8 and IL-10 values were higher, and a significant increase of IL-8 levels was found after 24 hours. The change in the SOFA score after 24 hours was significantly, although weakly, correlated with baseline IL-6 and IL-8 concentrations. CONCLUSIONS: Higher baseline IL-6, IL-8 and IL-10 levels are associated with unfavorable organ dysfunction outcomes. Increased IL-8 levels within the first 24 hours are correlated with a worsening dysfunction.
Keywords:CytokinesetiologyMultiple organ failureShock, septicsystemic inflammatory response syndromeSee more
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Original Article - Basic Research10-24-2011
Hemodynamic and perfusion variables during experimental septic shock treated with goal-directed fluid resuscitation
Revista Brasileira de Terapia Intensiva. 2011;23(3):283-290
Abstract
Original Article - Basic ResearchHemodynamic and perfusion variables during experimental septic shock treated with goal-directed fluid resuscitation
Revista Brasileira de Terapia Intensiva. 2011;23(3):283-290
DOI 10.1590/S0103-507X2011000300005
Views40See moreOBJECTIVES: Although fluid resuscitation guided by central venous oxygen saturation (SvcO2) is currently considered the gold standard in sepsis therapy, few studies have described hemodynamic and perfusion parameters during this procedure. This study aims to describe these parameters during septic shock without resuscitation and after 12 hours of goal-directed resuscitation. METHODS: Thirteen anesthetized pigs (35-45 kg) had peritonitis caused by fecal inoculation (0.75 g/kg). After developing persistent hypotension, both groups were given antibiotics and randomized either to the control group (n=7) or the experimental group (n=6). In the control group, hemodynamic control was optimized to maintain a central venous pressure of 8-12 mmHg, a urinary output above 0.5 mL/kg/hour and a mean arterial blood pressure above 65 mmHg. The experimental group received the above target therapy in addition to maintaining a SvO2 above 65%. The interventions included lactated Ringer's solution and norepinephrine for both groups and dobutamine in the SvO2 group. The animals were treated for 12 hours or until death. RESULTS: Untreated sepsis was associated with significant reductions in SvO2, PvO2, cardiac output and central venous pressure in addition to increased arteriovenous oxygen saturation and veno-arterial CO2 differences. Following resuscitation, these parameters were corrected in both groups. Goal-directed resuscitation was associated with a better hemodynamic profile, characterized by higher SvO2, cardiac output and central venous pressure. CONCLUSIONS: Non-resuscitated sepsis showed a hemodynamic profile suggesting hypovolemia, with worsened perfusion and hemodynamics, which is reversed upon fluid resuscitation. Goal-directed resuscitation is associated with significantly improved hemodynamic and perfusion parameters
Views40Abstract
Original Article - Basic ResearchHemodynamic and perfusion variables during experimental septic shock treated with goal-directed fluid resuscitation
Revista Brasileira de Terapia Intensiva. 2011;23(3):283-290
DOI 10.1590/S0103-507X2011000300005
Views40See moreOBJECTIVES: Although fluid resuscitation guided by central venous oxygen saturation (SvcO2) is currently considered the gold standard in sepsis therapy, few studies have described hemodynamic and perfusion parameters during this procedure. This study aims to describe these parameters during septic shock without resuscitation and after 12 hours of goal-directed resuscitation. METHODS: Thirteen anesthetized pigs (35-45 kg) had peritonitis caused by fecal inoculation (0.75 g/kg). After developing persistent hypotension, both groups were given antibiotics and randomized either to the control group (n=7) or the experimental group (n=6). In the control group, hemodynamic control was optimized to maintain a central venous pressure of 8-12 mmHg, a urinary output above 0.5 mL/kg/hour and a mean arterial blood pressure above 65 mmHg. The experimental group received the above target therapy in addition to maintaining a SvO2 above 65%. The interventions included lactated Ringer's solution and norepinephrine for both groups and dobutamine in the SvO2 group. The animals were treated for 12 hours or until death. RESULTS: Untreated sepsis was associated with significant reductions in SvO2, PvO2, cardiac output and central venous pressure in addition to increased arteriovenous oxygen saturation and veno-arterial CO2 differences. Following resuscitation, these parameters were corrected in both groups. Goal-directed resuscitation was associated with a better hemodynamic profile, characterized by higher SvO2, cardiac output and central venous pressure. CONCLUSIONS: Non-resuscitated sepsis showed a hemodynamic profile suggesting hypovolemia, with worsened perfusion and hemodynamics, which is reversed upon fluid resuscitation. Goal-directed resuscitation is associated with significantly improved hemodynamic and perfusion parameters
Original Article - Basic Research Archives - Critical Care Science (CCS)
