Am. J. Respir. Crit. Care Med.,
Volume 156, Number 6, December 1997, 1825-1833
Effects of Inter-
-inhibitor in Experimental Endotoxic
Shock and Disseminated Intravascular Coagulation
MERCÉ
JOURDAIN,
ODILE
CARRETTE,
ANTOINE
TOURNOYS,
FRANÇOIS
FOURRIER,
CHARLOTTE
MIZON,
JACQUES
MANGALABOYI,
JENNY
GOUDEMAND,
JACQUES
MIZON,
and
CLAUDE
CHOPIN
Equipe recommandée 150. DRED, Equipe associée 1052, DRED, Equipe d'accueil 1044. DRED, Université de Lille II, and Service de
Réanimation Polyvalente, Hôpital Roger Salengro, Lille, France
We investigated the effects of human inter-
-inhibitor (II) on hemodynamics, oxygenation, and coagulation parameters in a porcine model of endotoxic shock. Four groups of six animals were studied:
(1) control, (2) II group receiving 30 mg/kg II over 30 min, (3) LPS group receiving 5 µg · kg/min
Escherichia coli endotoxin over 30 min, and (4) LPS + II group receiving 30 min after endotoxin
30 mg/kg/30 min II. We measured hemodynamic and oxygenation parameters, usual coagulation
markers and plasma levels of thrombin-antithrombin complexes, antithrombin III activity, plasminogen activator tissue type, plasminogen activator inhibitor type 1, von Willebrand factor, tumor necrosis factor-, and II at baseline and at 30, 60, 90, 120, 180, 240, and 300 min. In the II group, plasma
II levels reached 447 ± 23 mg/L just after injection and 287 ± 39 mg/L at 300 min. II half-life was
7.3 ± 1.9 h. In the LPS + II group, II plasma levels decreased more rapidly, reaching 260 mg/L at
300 min. Compared with the LPS group, administration of II normalized the mean arterial pressure
and cardiac index, improved the LPS-induced pulmonary hypertension, and resulted in the blunted
increase in blood lactate and oxygen extraction ratio. A significant decrease in thrombin-antithrombin complexes and plasminogen activator inhibitor type 1 levels were observed. There was no significant difference in plasma tumor necrosis factor- levels. We concluded that in this hypodynamic model of endotoxin shock, II administration resulted in a marked improvement in the hemodynamic, oxygenation, and coagulation parameters.
