Anatomic Arterial-venous Shunting in Endotoxic and Septic Shock in Dogs

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Abstract
Shunting of radionuclide labeled 9 .mu. diameter microspheres by the systemic circulation and 6 body regions was measured in 2 dog shock models: endotoxic shock (1 mg/kg Escherichia coli endotoxin i.v.) and sepsis and septic shock (5 days after cecal ligation). Mean systemic arterial blood pressure was significantly lower than control in the endotoxic and septic shock groups. Mean systemic shunting was 7.7% in the control group and 7.3 and 4.3% respectively in the endotoxic and septic shock groups. Regional shunting of the head, heart and skeletal muscle were not significantly different in the 3 groups. Mean shunting in the splanchnic circulation was 36.5% in the septic shock group as compared to 18.6% in the control group (P < 0.05). Mean kidney shunting in the endotoxic group was 15.1% compared to 4% in the control group (P < 0.05). During resuscitation with crystalloid, mannitol, blood and cortiocosteroids mean arterial blood pressure and cardiac index increased, but systemic arterial-venous shunting was 3.8 and 4.3% in endotoxic and septic shock respectively. Systemic anatomic arterial-venous shunting is small and not different from control in both dog shock models, and regional arterial-venous shunting is increased only in the splanchnic circulation in the septic model and in the kidney in the endotoxin model.