Early hemodynamic indicators of gram-negative sepsis and shock in an infant pig model

To assess the hemodynamics of early shock and to determine to what extent hemodynamic indicators of sepsis and shock can be predictive, we evaluated data from several series of experiments (including 136 piglets) in which animals were subjected to fecal-Escherichia coli peritonitis-induced septic shock. Serial measurements of 39 parameters were obtained and their values taken at baseline, at hyperdynamic sepsis, and at shock were compared by analysis of variance. Piglet weights ranged from 1.2 to 7 kg (mean, 3.5) and ages ranged from 5 to 29 days (mean, 15). Of the 39 parameters assessed, 9 (CO*, CI*, SVI*, LVSWI*, SVR*, a-vDO2, VO2, O2 delivery*, and CaO2*) proved valuable as indicators of sepsis and shock. Of these parameters, seven (*) can be measured or calculated by noninvasive techniques and easily can be determined in human neonates. Serial determinations of these hemodynamics in high-risk neonates may be able to accurately predict gram-negative sepsis and shock before these entities are otherwise clinically apparent.