The effect of high volume hemofiltration on fluid resuscitation and the dosage of vascular active drug in early septic shock pigs

doi:10.3969/j.issn.1002-1949.2014.11.06

Abstract：Objective To explore the high volume hemofiltration (HVHF ) on fluid resuscitation and the dosage of vascular active drug in early septic shock .Mtehods Eighteen healthy pigs were injected endotoxin 50μg/kg via central vein within 30 minutes.After model establishment, all pigs were randomly divided into three groups ( n =6): control group, normal volume hemofiltration ( NVHF) group and high volume hemofiltration ( HVHF ) group.All the three groups were given mechanical ventilation.Lactic acid salinger liquid for fluid resuscitation was provided after septic shock model establishment, with stroke volume variation ( SVV) less than 10%as an index of liquid recovery termination;SVV would be kept lower than 10% by using intravenous infusion lactic acid salinger liquid.Continuous intravenous infusion of norepinephrine was used to maintain MAP on the basis of the value of more than 90%.Hemodynamic indexes were recorded before infusion endotoxin, 0 h after shock model establishment and 1, 2, 3, 4, 5, 6 h after they were given hemofiltration treatment;the quantity of fluid resuscitation and the dose of norepinephrine during the treatment were tracked.Results Compared with control group, after 1 hour's hemofiltration treatment, the quantity of lactic acid salinger liquid in HVHF group was significantly lower (P<0.05).The NVHF group in 1, 3, 4 hours, the quantity of lactic acid salinger liquid to maintain SVV<10%, was significantly decreased than that of the control group (P<0.05).After 2 hours'hemofiltration treatment, the dosage of lactic acid salinger liquid in HVHF group was significantly lower than NVHF group ( P <0.05 ).After 4 hours hemofiltration treatment, the dose of norepinephrine to sustain the MAP in HVHF group was obviously lower than those in NVHF group and control group, while NVHF group compared with control group has no significant statistical difference.Conclusion The application of HVHF in early septic shock can significantly reduce the quantity of fluid resuscitation and the dose of norepinephrine.