Effekte einer frühen Beatmung mit reinem Sauerstoff auf histomorphologische Parameter von Lunge und Leber im Langzeitmodell des septischen Schocks beim Schwein

Abstract

Objective: Early goal- directed therapy aims at balancing tissue oxygen delivery and demand. Hyperoxia (i. e. pure oxygen breathing) has not been studied in this context, since sepsis increases oxygen radical production, which is believed to be directly related to the oxygen tension. On the other hand, oxygen breathing improved survival in various shock models. Therefore, we hypothesized that hyperoxia may be beneficial during early septic shock. Design: Laboratory animal experiments. Setting: Animal research laboratory at university medical school. Subjects: Twenty domestic pigs of either gender. Interventions: After induction of fecal peritonitis, anesthetized and instrumented pigs were ventilated with either 100 % oxygen or supplemental oxygen as needed to maintain arterial hemoglobin oxygen saturation > 90 %. Normotensive and hyperdynamic hemodynamics were achieved using hydroxyethyl starch and norepinephrine infusion. Measurements and Main Results: Before and at 12, 18, and 24 hours of peritonitis, we measured lung compliance; systemic, pulmonary, and hepatosplanchnic hemodynamics; gas exchange; DNA strand breaks; organ function; SOD and catalase. Conclusions: During early hyperdynamic porcine septic shock, 100 % oxygen improved organ function and attenuated tissue apoptosis without affecting lung function and oxidative stress. Therefore, it might be considered as an additional measure in the first phase of early goal- directed therapy.