The effect of fluid resuscitation on cardiac function changes monitored by radionuclide ventriculography in the septic shock baboon model.

Abstract

Dramatic cardiac volume losses accompanied by a drop in arterial pressure and in pulmonary capillary wedge pressure (PCWP) were found to characterise the baboon model in bacterial septic shock. Loss of vascular tone and a probable vascular fluid leak were regarded as contributing factors. To prove this hypothesis an experiment was planned with the baboon model in septic shock, and an added protocol for fluid administration whereby the pulmonary wedge pressure was kept at 7 +/- 2 mm Hg. The six baboons served as their own controls. Raising PCWP by means of fluid loading resulted in an attenuation of the drop in left ventricular volumes, to a smaller decrease in stroke volume (SV) and smaller increases in left ventricular ejection fraction. The drop in arterial pressure remained and left ventricular stroke work therefore reflected the decrease in SV. Compliance as by EDV/PCWP remained unchanged. Fluid loading therefore, although not normalising the haemodynamic parameters, led to smaller changes and an improvement in some measures of cardiac function.