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Article

Small-Volume Hypertonic Saline/Pentastarch Improves Ileal Mucosal Microcirculation in Experimental Peritonitis

by
Abdelnasser Assadi
1,*,
Olivier Desebbe
1,3,
Thomas Rimmelé
1,2,
Arnal Florence
1,
Joëlle Goudable
5,
Dominique Chassard
4 and
Bernard Allaouchiche
1,2
1
Inserm ERI 22, Agressions vasculaires- Réponses tissulaires, Claude Bernard University-Lyon 1, Lyon, France
2
Department of Anesthesiology and Intensive Care, Edouard Herriot Hospital, Lyon, France
3
Department of Anesthesiology and Intensive Care, Louis Pradel Hospital, Lyon, France
4
Department of Anesthesiology and Intensive Care, Mére-enfant Hospital, Lyon, France
5
Laboratory of Biochemistry, Edouard Herriot Hospital, Lyon, France
*
Author to whom correspondence should be addressed.
Infect. Dis. Rep. 2012, 4(1), e22; https://doi.org/10.4081/idr.2012.e22
Submission received: 6 October 2011 / Revised: 6 October 2011 / Accepted: 8 January 2012 / Published: 5 March 2012

Abstract

We compared the effects of hypertonic saline 7.2%/6% hydroxyethyl starch (HSS-HES) and isotonic saline 0.9%/6% hydroxyethyl starch (ISS-HES) on ileal microcirculatory blood flow (MBF) at the initial phase of septic shock. Pigs were anesthetized and mechanically ventilated. Catheters were inserted into right atrium, pulmonary artery, carotid artery, and portal vein for hemodynamic measurements and for blood sampling. Ileal mucosal and muscularis MBF was continuously measured by laser Doppler flowmetry (LDF). Septic shock was obtained 240 min after induction of fecal peritonitis; then animals were randomized to receive 10 mL.kg-1 during 10 min of either HSS-HES or ISS-HES. Systemic and microcirculatory blood flow as well as systemic metabolism were assessed. Fecal peritonitis promoted a hypodynamic septic shock, with significant reduction of mean arterial pressure (MAP) and cardiac index (CI). Ileal mucosal MBF (-34%) and ileal muscularis MBF (-54%) significantly diminished from baseline. Contrary to ISS-HES group, mucosal MBF significantly augmented after HSS-HES (+192% at min 150 post-shock) despite low blood pressure. There was weak correlation with CI (r²= 0.2, P = 0.01) . Muscularis MBF didn’t change. HSS-HES-treated animals had a significantly higher osmolarity and sodium concentration than ISS-HES group. Other variables did not change. Small-volume resuscitation with HSS-HES, but not ISS-HES, improved ileal microcirculatory impairment in experimental peritonitis model of septic shock even when MAP was low. This beneficial microcirculatory effect could be valuable in the management of early severe sepsis.
Keywords: hydroxyethylstarch, hypertonic saline, laser Doppler flowmetry, microcirculation, septic shock, splanchnic perfusion hydroxyethylstarch, hypertonic saline, laser Doppler flowmetry, microcirculation, septic shock, splanchnic perfusion

Share and Cite

MDPI and ACS Style

Assadi, A.; Desebbe, O.; Rimmelé, T.; Florence, A.; Goudable, J.; Chassard, D.; Allaouchiche, B. Small-Volume Hypertonic Saline/Pentastarch Improves Ileal Mucosal Microcirculation in Experimental Peritonitis. Infect. Dis. Rep. 2012, 4, e22. https://doi.org/10.4081/idr.2012.e22

AMA Style

Assadi A, Desebbe O, Rimmelé T, Florence A, Goudable J, Chassard D, Allaouchiche B. Small-Volume Hypertonic Saline/Pentastarch Improves Ileal Mucosal Microcirculation in Experimental Peritonitis. Infectious Disease Reports. 2012; 4(1):e22. https://doi.org/10.4081/idr.2012.e22

Chicago/Turabian Style

Assadi, Abdelnasser, Olivier Desebbe, Thomas Rimmelé, Arnal Florence, Joëlle Goudable, Dominique Chassard, and Bernard Allaouchiche. 2012. "Small-Volume Hypertonic Saline/Pentastarch Improves Ileal Mucosal Microcirculation in Experimental Peritonitis" Infectious Disease Reports 4, no. 1: e22. https://doi.org/10.4081/idr.2012.e22

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