Pentastarch in a balanced solution reduces hepatic leukocyte recruitment in early sepsis

To characterize the hepatic leukocyte endothelial cell interactions occurring in early sepsis and to determine whether this is influenced by fluid treatment.

Sepsis was induced by cecal ligation and perforation in C57Bl/6 mice. One of 6 iv fluid regimes was given immediately postsurgery and at 6 h. The hepatic microcirculation was examined by intravital microscopy at 6 h.

All 0.9% saline-based solutions were associated with an increase in leukocyte-endothelial cell interactions as demonstrated by an increase in the rolling flux in the sham and naïve mice. In the septic mice treated with normal saline, there was a 20-fold increase in leukocyte adhesion within the postsinusoidal venules, compared to sham mice. Treatment with lactated Ringer's reduced the sepsis-mediated leukocyte recruitment by 50%. When septic mice received 6% pentastarch in a balanced solution or 3% saline, venular leukocyte adhesion was reduced by an additional 50%. When the pentastarch was prepared in normal saline there was no further reduction in venular leukocyte adhesion compared to the lactated Ringer's-treated mice. All hyperosmolar solutions improved the sepsis-induced reduction in sinusoidal perfusion but only the pentastarch in the balance solution significantly reduced the number of adherent leukocytes within the sinusoids.

Hepatic leukocyte recruitment occurs early in sepsis. Pentastarch in a balanced solution but not in normal saline significantly reduces hepatic leukocyte recruitment, suggesting solution composition, as well as osmolarity impact the innate immune response.