Abstract

BackgroundAcute ethanol intoxication has been shown to have contrasting effects on outcomes in sepsis. The aim of this study was to explore the effects of acute ethanol intoxication on hemodynamics, renal function, brain perfusion and lactate/pyruvate in an ovine sepsis model.MethodsAnesthetized, mechanically ventilated female sheep were randomized to an ethanol group (n = 7), which received 1 g/kg ethanol diluted in intravenous (i.v.) saline infusion or a control group (n = 7), which received the same volume of i.v. saline. Both groups received the treatment for a period of 2 h prior to induction of sepsis by intraperitoneal injection of feces. Other treatment included fluid resuscitation but no vasopressors or antibiotics. Global hemodynamics, renal blood flow, brain cortex laser Doppler flowmetry and microdialysis analyses were recorded hourly.ResultsIn the ethanol group, blood ethanol concentrations were 137 ± 29 mg/dL at the time of feces injection and decreased to become undetectable by 12 h. Arterial hypotension occurred earlier in the ethanol than in the control group (8 [7–12] vs. 14 [11–20] hours, p = 0.03). Lactate levels increased to > 2 mmol/L earlier in the ethanol group. Renal dysfunction (9 [6–13] vs. 13 [12–15] hours, p = 0.05) and oliguria (urine output < 0.5 mL/kg/h; 10 [7–12] vs. 13 [12, 13] hours, p = 0.01) developed earlier in the ethanol than in the control group. Brain blood flow and lactate/pyruvate were unaffected. There was no significant difference in survival time.ConclusionsAcute ethanol intoxication in this model of peritonitis resulted in earlier development of shock and renal dysfunction but did not alter brain perfusion and metabolism or short-term survival.

Highlights

  • Acute ethanol intoxication has been shown to have contrasting effects on outcomes in sepsis

  • Lower systemic interleukin (IL)-6 levels and leukocyte counts have been reported in traumatic brain injury (TBI) patients with acute ethanol intoxication [17], suggesting an immunosuppressive effect of ethanol, in this study there were no significant differences in occurrence of sepsis or pneumonia in patients with positive or negative ethanol tests

  • We tested the hypothesis that acute ethanol intoxication may have deleterious hemodynamic effects that could affect kidney and brain perfusion and brain lactate/ pyruvate ratio in a large sheep model of fecal peritonitis

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Summary

Introduction

Acute ethanol intoxication has been shown to have contrasting effects on outcomes in sepsis. The aim of this study was to explore the effects of acute ethanol intoxication on hemodynamics, renal function, brain perfusion and lactate/pyruvate in an ovine sepsis model. Lower systemic interleukin (IL)-6 levels and leukocyte counts have been reported in TBI patients with acute ethanol intoxication [17], suggesting an immunosuppressive effect of ethanol, in this study there were no significant differences in occurrence of sepsis or pneumonia in patients with positive or negative ethanol tests. We tested the hypothesis that acute ethanol intoxication may have deleterious hemodynamic effects that could affect kidney and brain perfusion and brain lactate/ pyruvate ratio in a large sheep model of fecal peritonitis

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