Hypertonic sodium lactate improves fluid balance and hemodynamics in porcine endotoxic shock

Introduction Based on the potential interest in sodium lactate as an energy substrate and resuscitative fluid, we investigated the effects of hypertonic sodium lactate in a porcine endotoxic shock. Methods Fifteen anesthetized, mechanically ventilated pigs were challenged with intravenous infusion o...
Ausführliche Beschreibung

Introduction Based on the potential interest in sodium lactate as an energy substrate and resuscitative fluid, we investigated the effects of hypertonic sodium lactate in a porcine endotoxic shock. Methods Fifteen anesthetized, mechanically ventilated pigs were challenged with intravenous infusion of E. coli endotoxin. Three groups of five animals were randomly assigned to receive 5 mL/kg/h of different fluids: a treatment group received hypertonic sodium lactate 11.2% (HSL group); an isotonic control group receiving 0.9% NaCl (NC group); a hypertonic control group with the same amount of osmoles and sodium than HSL group receiving hypertonic sodium bicarbonate 8.4% (HSB group). Hemodynamic and oxygenation variables, urine output and fluid balance were measured at baseline and at 30, 60, 120, 210 and 300 min. Skin microvascular blood flow at rest and during reactive hyperemia was obtained using a laser Doppler flowmetry technique. Results were given as median with interquartile ranges. Results Endotoxin infusion resulted in hypodynamic shock. At 300 min, hemodynamics and oxygenation were significantly enhanced in HSL group: mean arterial pressure (103 [81–120] mmHg vs. 49 [41–62] in NC group vs. 71 [60–78] in HSB group), cardiac index (1.6 [1.2–1.8] L/min/$ m^{2} $ vs. 0.9 [0.5–1.1] in NC group vs. 1.3 [0.9–1.6] in HSB group) and partial pressure of oxygen (366 [308–392] mmHg vs. 166 [130–206] in NC group vs. 277 [189–303] in HSB group). At the same time, microvascular reactivity was significantly better in HSL group with a lower venoarterial $ CO_{2} $ tension difference (5.5 [4–10] mmHg vs. 17 [14–25] in NC group vs. 14 [12–15] in HSB group). The cumulative fluid balance was lower in HSL group (-325 [-655; -150] mL) compared to NC (+560 [+230; +900] mL, p = 0.008) and HSB (+185 [-110; +645] mL, p = 0.03) groups. Conclusions In our hypodynamic model of endotoxic shock, infusion of hypertonic sodium lactate improves hemodynamic and microvascular reactivity with a negative fluid balance and a better oxygenation. Ausführliche Beschreibung

Autor*in:	Duburcq, Thibault [verfasserIn] Favory, Raphaël Mathieu, Daniel Hubert, Thomas Mangalaboyi, Jacques Gmyr, Valery Quintane, Laurence Maboudou, Patrice Pattou, François Jourdain, Mercé

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2014

Schlagwörter:	Mean Arterial Pressure Pulmonary Capillary Wedge Pressure Reactive Hyperemia Mean Pulmonary Arterial Pressure Perfusion Unit

Anmerkung:	© Duburcq et al., licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (

Übergeordnetes Werk:	Enthalten in: Critical care - London : BioMed Central, 1997, 18(2014), 4 vom: 14. Aug.
Übergeordnetes Werk:	volume:18 ; year:2014 ; number:4 ; day:14 ; month:08

Links:	Volltext

DOI / URN:	10.1186/s13054-014-0467-3

Katalog-ID:	SPR029871913