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Effect of mechanical ventilation on systemic oxygen extraction and lactic acidosis during early septic shock in rats

We studied the effect of mechanical ventilation on systemic oxygen extraction and lactic acidosis in peritonitis and shock in rats. Sepsis was induced by cecal ligation and perforation. After tracheostomy, rats were randomized to spontaneous breathing (S) or mechanical ventilation with paralysis (V). Five animals were studied in each group. The V animals were paralyzed with pancuronium bromide to eliminate respiratory effort. Mechanical ventilation consisted of controlled ventilation using a rodent respirator with periodic adjustment of minute ventilation to maintain Paco2 and pH within normal range. Arterial and central venous blood gases and thermodilution cardiac output were measured at baseline before abdominal surgery, and sequentially at 0.5, 3.5, and 6 h after surgery. At 6 h, cardiac output was 193 ± 30 ml/kg min in S animals and 199 ± 32 ml/kg min in V animals (NS). The central venous oxygen saturation was 27.4 ± 4.7% in S animals and 30.0 ± 6.4% in V animals (NS). Systemic oxygen extraction was 70 ± 5% in S animals and 67 ± 6% in V animals (NS). Arterial lactate was 2.4 ± 0.4 mmol/L in S animals and 2.2 ± 0.5 mmol/L in V animals (NS). The S animals developed lethal hypotension at 6.6 ± 0.4 h compared to 6.8 ± 0.4 h in V animals (NS). These data suggest that mechanical ventilation does not decrease systemic oxygen extraction or ameliorate the development of lactic acidosis during septic shock.