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Laboratory and Animal Investigations |

Vital Organ Blood Flow During Hyperdynamic Sepsis*

David Di Giantomasso; Clive N. May; Rinaldo Bellomo
Author and Funding Information

*From the Howard Florey Institute, Parkville, Melbourne; and Department of Intensive Care, Austin & Repatriation Medical Centre, Heidelberg, Melbourne, Australia.

Correspondence to: Rinaldo Bellomo, MD, Department of Intensive Care, Austin & Repatriation Medical Centre, Heidelberg, VIC 3084, Australia; e-mail: rinaldo.bellomo@armc.org.au



Chest. 2003;124(3):1053-1059. doi:10.1378/chest.124.3.1053
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Objectives: To develop a nonlethal model of hyperdynamic sepsis, and to measure vital organ blood flows in this setting.

Design: Randomized crossover animal study.

Setting: Animal laboratory of university-affiliated physiology institute.

Subjects: Seven Merino cross sheep.

Interventions: Surgical implantation of transit-time flow probes around sagittal sinus and circumflex coronary, superior mesenteric, and left renal arteries, and of an electromagnetic flow probe around the ascending aorta. After recovery, randomization to either 6 h of observation under normal conditions (control) or 6 h of observation after the induction of hyperdynamic nonlethal sepsis (sepsis), with each animal crossing over to the other treatment after a 2-week interval.

Measurements and main results: Injection of Escherichia coli induced nonlethal hyperdynamic sepsis within 5 to 6 h with hypotension (mean arterial pressure [± SD], 85 ± 7 mm Hg vs 69 ± 8 mm Hg), increased cardiac output (4.0 ± 0.9 L/min vs 7.2 ± 1.2 L/min), tachycardia (60 ± 10 beats/min vs 160 ± 15 beats/min), fever, oliguria, and tachypnea. Compared to control animals, hyperdynamic sepsis increased renal (330 ± 101 mL/min vs 214 ± 75 mL/min), mesenteric (773 ± 370 mL/min vs 516 ± 221 mL/min), and coronary (54 ± 24 mL/min vs 23 ± 10 mL/min) blood flow (p < 0.05). There was no significant change in sagittal sinus flow. Despite increased coronary flow, myocardial contractility decreased (800 ± 150 L/min/s vs 990 ± 150 L/min/s). Despite increased mesenteric and renal blood flow, there was hyperlactatemia (0.5 ± 0.1 mmol/L vs 1.9 ± 0.3 mmol/L); despite increased renal blood flow, all experimental animals acquired oliguria (160 ± 75.3 mL/2 h vs 50.2 ± 13.1 mL/2 h) and increased serum creatinine levels (0.07 ± 0.02 mmol/L vs 0.11 ± 0.02 mmol/L).

Conclusions: Injection of E coli induced hyperdynamic nonlethal sepsis. During such hyperdynamic sepsis, blood flow to heart, gut, and kidney was markedly increased; however, organ dysfunction developed. We speculate that global ischemia may not be the principal mechanism of vital organ dysfunction in hyperdynamic sepsis.

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