The Changes Of Glycocalyx For Septic Shock And The Influence Of Difference Doses Of Fluid Resuscitation For Septic Shock

Objective: The doses of fluid resuscitation for Septic shock is now a complicated question in the clinical practice.we attempt to investigate the changes of endotheliocyte glycocalyx in the resuscitation of animal model with Septic shock to infer the relatively appropriate fluid doses.Methods: 20 New Zealand albino rabbits were divided into two sets:sepsis group and control group,and the sepsis group was divided into three parts:low dose group(30 ml/Kg liquid recovery)high dose group(60ml/Kg liquid recovery)and pure sepsis group(not liquid recovery).Each group has 5 laboratory animals.The preparation of the animal model of sepsis adopted LPS methods,and the control group animals got the same dose of 5%glucose injection into the ear vein.we started to monitor the invasive arterial blood pressure(ABP),mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SPO2)from the biological signal collection and processing system connected with left arteria carotis communis with pressure transducer after two hours of injection(The control group for glucose injection).We did give the fluid resuscitation and application of vasoactive agent through the right internal jugular vein indwelling catheter,and extract internal carotid arteries and veins blood in the time point: 0h?3h?6h.we measured the monitor lactic acid concentration,blood gas analysis,the concentration of Syndecan-1,respiratory frequency,consciousness and visual animals exposed part(oral,ear margin veins)for myocardial microperfusion.Results:1 0h after LPS: The blood pressure of sepsis group was significantly lower,the heart rate and breathing rate for it increased faster.Lactic acid concentration:the sepsis group?the control group,Results the differences of the results were statistically significant in two groups(P<0.05).There were no statistical differences compared with the:low dose group,high dose group and pure sepsis group respectively.The results of SCVO2(central venous oxygen saturation)were same to the concentration of lactic acid.Syndecan-1:the sepsis group ? the control group.Results the differences of the results were statistically significant in two groups(P<0.05).2 3h after LPS: The fluid resuscitation was completed in 1 hour after LPS,and we adjust the dosage of norepinephrine according to the mean arterial pressure(MAP?65mm Hg).3h Syndecan-1 concentration:the sepsis group?the control group,and results the differences were statistically significant in two groups(P<0.05).Comparison of the the sepsis group,low dose group,high dose group and pure sepsis group respectively:the sepsis group?high dose group?low dose group?pure sepsis group,and results the differences were statistically significant(P<0.05).3 6h after LPS: Syndecan-1: The highest concentration of Syndecan-1was in the sepsis group(comparison respectively),and the results had statistically significant.There were no statistically significant in the difference of high dose group,low dose group and pure sepsis group.But,the mean value ranking was as follows:high dose group?low dose group?pure sepsis group.4 In a self contrast:The Syndecan-1 in the low dose group changed a little,and the difference of before and after the experiment did not has a statistically significant.The Syndecan-1 in the high dose group changed a lot.It trended to increase(0h?3h?6h)and the difference got a statistically significant.The Syndecan-1 in the pure sepsis group changed a lot.It trended to increase(0h?3h ? 6h)and the difference between 0h and 3h did not got a statistically significant,but the difference between 3h and 6h got a statistically significant.The Syndecan-1 in the control group changed a little,but the difference(6h was a little higher than the other two)between 6h and 0h as well as the difference between 6h and 3h got a statistically significant.5 Factorial analysis without time factor: Syndecan-1:the sepsis group?high dose group?low dose group,and results the differences were statistically significant(P<0.05).The concentration of the low dose group was higher than the control group,but the difference did not got a statistically significant.Conclusions: From establishing animal models with Sepsis Shock that which were received with different doses of fluid resuscitation and detected the concentration of endotheliocyte glycocalyx markers,we may prove that conservative dose of fluid resuscitation with vasoactive drug may decrease the falling off of the structure of glycocalyx,and it may also improving the function of endothelial cell and vascular permeability of patients.