Key result
5% sodium bicarbonate improves hemodynamics and cardiac function over normal saline in endotoxic shock.
Why the study?
A macaque model of early-phase endotoxic shock and the effects of different fluid resuscitation solutions were not previously established.
Establishes macaque endotoxic shock model; leaves open translation of bicarbonate or hypertonic saline resuscitation to human sepsis.
These studies established a macaque model of early-phase endotoxic shock, and investigated the resuscitation effects of three different solutions. Twenty-four macaques were assigned to four groups. Nineteen animals were given an intravenous dose of 2.8 mg/kg lipopolysaccharide (LPS). At 60 min after LPS challenge, the animals were given (i) 5 mL/kg normal saline (Ns group, n=6), (ii) 5% of 5 mL/kg sodium bicarbonate (Sb group, n=6), (iii) hypertonic 3.5% sodium chloride of 5 mL/kg (Hs group, n=7). The control group (Co group, n=5) was first injected with 1 mL/kg Ns and with 5 mL/kg Ns 60 min later. Haemodynamic parameters and blood gases were measured during the experiment, and myocardial morphology was examined on termination of the experiment. Administration of LPS caused hypotension and decreases of the left ventricular work index (LVWI). In the Sb group, mean arterial pressure, cardiac index, systemic vascular resistance index, LVWI and right ventricular work index were significantly higher than those of the Ns group. Pathological changes of myocardium were identified in all of the LPS groups. The studies suggest that macaques are suitable models for studying endotoxic shock and potential fluid therapies.
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Yin et al. (2005) studied Endotoxic shock (n=24). Fluid resuscitation (5% sodium bicarbonate, normal saline, or hypertonic 3.5% sodium chloride) vs. Control group (no LPS) and normal saline group was evaluated on Haemodynamic parameters, blood gases, and myocardial morphology. Resuscitation with 5% sodium bicarbonate significantly improved mean arterial pressure, cardiac index, and ventricular work indices compared to normal saline in a macaque model of endotoxic shock.
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