Prevention of death in endotoxin shock by glucose administration

L. B. Hinshaw, M. D. Peyton, L. T. Archer, M. R. Black, J. J. Coalson, L. J. Greenfield

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Abstract

Current interest has centered around the role of glucose metabolism in shock and trauma. The present study was undertaken to determine the relationships of arterial blood glucose levels to hemodynamics, acid base parameters, and survival in dogs administered an LD 70 E. coli endotoxin. Experiments were carried out on anesthetized adult dogs which were free of intestinal parasites as well as heart worms and which were fasted overnight. Mean systemic arterial pressure, heart rate, arterial pH, pCO 2, pO 2, hematocrit level, and rectum temperature were monitored during a 5 hr postendotoxin period. Hematocrit values were maintained constant with 6% dextran, and all surviving dogs were observed for 30 hr. 8 of 11 dogs given 1 mg per kg of endotoxin alone died in a mean time of 13 hr with marked hypoglycemia, while 3 dogs which maintained their glucose levels survived. 9 additional dogs administered endotoxin were infused intravenously with 50% dextrose at rates sufficient to maintain blood glucose levels at control values, and all of these dogs survived. Arterial blood pressure changes were similar in both groups, while heart rate, rectal temperature, and pH were elevated within 5 hr in dogs receiving glucose. A second series of dogs was studied in which treatment was begun only when the dogs became severly hypoglycemic after 1.0 to 1.5 mg per kg of endotoxin. 5 dogs in this group were infused with glucose for up to 7 hr postendotoxin and all survived. 10 dogs not receiving glucose died after hypoglycemic levels were reached. These results document progressively developing hypoglycemia in canine endotoxin shock. A positive correlation is shown to exist between endogenously maintained blood glucose levels and survival time. Exogenously administered glucose which maintains blood glucose levels constant in dogs after endotoxin improves certain cardiovascular and metabolic parameters and prevents death.

Original languageEnglish (US)
Pages (from-to)851-859
Number of pages9
JournalSurgery Gynecology and Obstetrics
Volume139
Issue number6
StatePublished - Dec 1 1974

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ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology

Cite this

Hinshaw, L. B., Peyton, M. D., Archer, L. T., Black, M. R., Coalson, J. J., & Greenfield, L. J. (1974). Prevention of death in endotoxin shock by glucose administration. Surgery Gynecology and Obstetrics, 139(6), 851-859.