dc.creatorRAHAL, Luciana
dc.creatorGARRIDO, Alejandra G.
dc.creatorCRUZ JR., Ruy J.
dc.creatorSILVA, Eliezer
dc.creatorPOLI-DE-FIGUEIREDO, Luiz F.
dc.date.accessioned2012-10-19T18:24:45Z
dc.date.accessioned2018-07-04T15:11:58Z
dc.date.available2012-10-19T18:24:45Z
dc.date.available2018-07-04T15:11:58Z
dc.date.created2012-10-19T18:24:45Z
dc.date.issued2009
dc.identifierJOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, v.67, n.6, p.1205-1212, 2009
dc.identifier0022-5282
dc.identifierhttp://producao.usp.br/handle/BDPI/23174
dc.identifier10.1097/TA.0b013e31818b2567
dc.identifierhttp://dx.doi.org/10.1097/TA.0b013e31818b2567
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1619904
dc.description.abstractBackground: Splanchnic perfusion is prone to early injury and persists despite normalization of global hemodynamic variables in sepsis. Volume replacement guided by oxygen derived variables has been recommended in the management of septic patients. Our hypothesis was that a hypertonic isoneotic solution Would improve the benefits of crystalloids replacement guided by mixed venous oxygen saturation. Methods: Seventeen anesthetized and mechanically ventilated mongrel dogs received an intravenous infusion of live E. coli in 30 minutes. They were then randomized into three groups: control group (n = 3) bacterial infusion without treatment; normal saline (n = 7), initial fluid replacement with 32 mL/kg of normal saline during 20 minutes; hypertonic solution (n = 7), initial fluid replacement with 4 mL/kg of hypertonic solution during 5 minutes. After 30 and 60 Minutes, additional boluses of normal saline were administered when mixed venous oxygen saturation remained below 70%. Mean arterial pressure, cardiac output; regional blood flows, systemic and regional oxygen-derived variables, and lactate levels were assessed. Animals were observed for 90 minutes and then killed. Hystopathological analysis including apoptosis detection using terminal deoxynucleotidil transferase mediated dUTP-biotin nick end labeling was performed. Results: A hypodynamic septic shock was observed after bacterial infusion. Both the fluid-treated groups presented similar transient benefits in systemic and regional variables. A greater degree of gut epithelial cells apoptosis was observed in normal saline-treated animals. Conclusions: Although normalization of mixed venous oxygen saturation was not associated with restoration of markers of splanchnic or other systemic perfusion variables, the initial fluid savings with hypertonic saline and its latter effect on gut apoptosis may be of interest in sepsis management.
dc.languageeng
dc.publisherLIPPINCOTT WILLIAMS & WILKINS
dc.relationJournal of Trauma-injury Infection and Critical Care
dc.rightsCopyright LIPPINCOTT WILLIAMS & WILKINS
dc.rightsrestrictedAccess
dc.subjectApoptosis
dc.subjectEscherichia coli
dc.subjectHypertonic saline solutions
dc.subjectSepsis
dc.subjectShock
dc.subjectSplanchnic perfusion
dc.titleFluid Replacement With Hypertonic or Isotonic Solutions Guided by Mixed Venous Oxygen Saturation in Experimental Hypodynamic Sepsis
dc.typeArtículos de revistas


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