Effects of plasma administration on gram negative shock in granulocytopenic dogs

We studied the effect of an infusion of citrated plasma on the hemodynamic response and bacterial clearance of acutely septic dogs rendered severely neutropenic with cyclophosphamide. Two hours after a 5 X 10(9)/kg intravenous injection of E. coli, neutropenic control dogs infused with 20 ml/kg of normal saline became hypotensive and remained so for the next 2 hr. In contrast, the infusion of 20 ml/kg of citrated plasma after the initiation of bacteremia was followed by a significant (P less than .01) improvement in the mean arterial pressure (MAP), compared to saline-treated animals. The effect of citrated plasma administration on MAP was unrelated to bacterial clearance or to improvement in cardiac output but was associated with an increase in total peripheral resistance that was sustained for 2 hr after plasma infusion. The infusion of hyperimmune plasma from dogs previously immunized to core glycolipid antigen appeared to have no important advantage over normal plasma. At the doses of plasma that were given, a relatively higher arterial pH was the only observed significant difference (P less than .05) when immune plasma was compared to normal plasma. Resuscitation of septic neutropenic dogs with large volumes of plasma deserves further study with respect to the specific mechanisms responsible for its beneficial effect.