[Effect of fluid resuscitation on capillary permeability and vascular endothelial growth factor in dogs with septic shock].

OBJECTIVE

To evaluate the change in capillary permeability and vascular endothelial growth factor (VEGF) after resuscitation with different fluids in dogs with septic shock, and to investigate the possible mechanism and treatment of capillary leak syndrome.

METHODS

Model of septic shock in mongrel dogs was replicated by intestinal punctures and peritonitis. Twenty-four dogs with septic shock were randomly divided into three groups according to the fluids used in resuscitation: group I : 0.9% NaCl, group II : 7.5% NaCl, group III : hydroxyethyl starch (HES130/0.4). Dogs were infused with different fluids (20 ml x kg(-1) x h(-1)) to restore to the goal as specified in the guideline, and mean arterial pressure (MAP) was maintained at maximum for 60 minutes. The infusion volume of each group, resuscitation time and maintaining time were recorded. VEGF of plasma was determined with method of enzyme-linked immunoadsorbent assay (ELISA). Evans blue (EB) was injected intravenously 30 minutes before the dogs were sacrificed, and lungs were removed for pathological examination. Lung water content was determined. Lung EB content was determined by formamide extracting method. The expression of VEGF in lungs was evaluated by immunohistochemistry.

RESULTS

The infusion volumes and time consumed were significantly higher in group I than those in any other groups (P<0.05 or P<0.01), and maintaining time, lung water and EB contents were significantly lower in group III than those in any other groups (P<0.05 or P<0.01). Concentrations of VEGF before septic shock were lower than those after septic shock, and increased after resuscitation, especially in group III at 2 hours after resuscitation (all P<0.05). VEGF expressions in lung tissues of each group after resuscitation were less intense than those after shock, especially in group III.

CONCLUSION

When the effect of 0.9% NaCl and 7.5% NaCl was compared with HES130/0.4, it is shown that the latter is more superior in decreasing capillary permeability, concentration of VEGF and attenuating pulmonary edema.