Biventricular function during volume loading in porcine E. coli septic shock, with emphasis on right ventricular function.

In 14 anesthesized pigs, the effect of E. coli (2 X 10(8)/kg) and volume loading on hemodynamics and right and left ventricular performance were studied. Autologous red cells were labeled in vitro with 99mTC (15-20 mCi). Gated blood pool studies and hemodynamics were performed simultaneously. E. coli infusion resulted in an abrupt increase in pulmonary artery pressure, whereas systemic blood pressure fell gradually. Gated studies showed a transient increase in right ventricular end-diastolic volume (RVEDV) after 1 hour; left ventricular end-diastolic volume (LVEDV) declined gradually during sepsis. During volume loading, RVEDV and LVEDV both increased. As estimated from the altered Frank Starling relation between preload and SW, a depressed performance of both left and right ventricle was found. We conclude that volume expansion in porcine E. coli septic shock results in a uniform increase of left and right preload despite a substantial increase in pulmonary vascular resistance.