Microcirculatory effects of fluid therapy and dopamine,associated or not to fluid therapy,in endotoxemic hamsters

Abstract

Classically septic shock treatment takes into consideration only systemic parameters but failure in retaining arteriolar blood flow and functional capillary density (FCD) during sepsis worsens the outcome. Thus, we have investigated the effects of vigorous volume resuscitation (VR), two doses of dopamine and their combination upon the microcirculation during endotoxemia to evaluate if improvement on FCD and arteriolar blood flow would increase survival time. Sixty-seven adult male hamsters were studied using the window chamber model. Animals were randomized 1 h after the intravenous injection of 1 mg/kg of E. coli lipopolysaccharide (LPS) in LPS, no treatment; LPS/dopamine 3.0 μg/kg/min; LPS/dopamine 7.5 μg/kg/min; LPS/VR 20 ml/kg in 30 min followed by 20 ml/kg/h of saline; LPS/VR/Dopa 3.0, 20 ml/kg in 30 min followed by 20 ml/kg/h of saline associated to dopamine 3.0 μg/kg/min; LPS/VR/Dopa 7.5 (n = 6), 20 ml/kg in 30 min followed by 20 ml/kg/h of saline associated to dopamine 7.5 μg/kg/min and compared them to a Control group, no LPS. When present, treatment lasted 5 h. VR improved FCD and arteriolar blood flow score while dopamine did not. In conclusion, (1) improvement of FCD and arteriolar blood flow improved survival time; (2) VR recovered FCD and arteriolar blood flow and (3) in combination to VR, both dopamine doses reduced tissue perfusion (its low dose yielded the worst result).