The effects of
Ringer's acetate, 6% dextran-70, 7.5% NaCl, and the combination of 7.5% NaCl and dextran-70 were tested in
resuscitation from
endotoxin shock induced by continuous iv infusion of
Escherichia coli endotoxin in pigs. After about 3 h, a reproducible
shock state was achieved and treatment was started, governed by the left atrial pressure. The
hypertonic solutions (7.5% NaCl and 7.5% NaCl in
dextran-70) did not show any overall advantages over the
isotonic solutions (
Ringer's acetate and
dextran-70). Only transient beneficial hemodynamic effects lasting less than 30 min after infusion were seen. When dextran-70 was administered, cardiovascular function was markedly improved and
oxygen delivery (DO2) and survival were significantly higher compared with the
crystalloid groups (
Ringer's acetate and 7.5% NaCl). Administration of large amounts of
Ringer's acetate resulted in an immediate deterioration of pulmonary function. It was difficult to elevate left atrial pressure or even to keep it at baseline level, and cardiac index was only transiently increased. The overall result was a deterioration of DO2 and poor survival compared with the dextran-70 treated pigs. We conclude that dextran-70 is superior to
Ringer's acetate in
resuscitation from
endotoxin-induced
shock in pigs. Furthermore, we found no role for the use of hypertonic saline, alone or in combination with
dextran, in the treatment of this type of prolonged
endotoxin shock.