N the presence of antibiotics. Thus, it has a potential to
N the presence of antibiotics. Thus, it has a potential to be used as an adjunct immunomodulatory agent during acute inflammatory conditions PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/27488460 like ALI or sepsis.Background: Fluid replacement has been a usually recommended maneuver in sepsis; however, growing clinical controversies in the management of critically ill patients with severe sepsis have questioned its benefit. Herein, we evaluated the effect of a rapid hyperhydration (HH) therapy in varying stages of sepsis. Materials and methods: Wistar-EPM rats, weighing 200 to 250 g, were submitted to two sepsis models: S8 group, submitted to 2 ml Escherichia coli 10 8 CFU/ml intravenous (i.v.) inoculation, LD 60 , or S9 group, with E. coli 109 CFU/ml inoculation, LD80. Both groups were treated with HH (30 ml/kg of Ringer lactate i.v., in 20 minutes) in the early (E30 minute) and late (L6 hour) phases of sepsis. The mortality was followed up to 30 days (n = 6/group) and the splanchnic microcirculation was monitored by sidestream dark field imaging (SDF) video microscopy at 6-hour and ABT-737 cost 24-hour periods (n = 3/group/period). Results: The HH at the E30 minute phase of S8 improved the survival rate from 40 to 90 , and L6 hour phase HH promoted an 80 survival rate. Besides, the survival rate in S9 (LD80), with E30 minute HH, improved the survival rate from 20 to 50 . However, it was less effective as compared with the E6H phase HH, which resulted in an expressive survival rate (from 20 to 70 ). These intriguing results suggested that there is an interdependent and time-dependent pathophysiology feature within the host response based on sepsis severity stage and a rapid high-volume reposition. The SDF analysis in control sepsis groups (S8 and S9), without fluid therapy, showed a broadly distributed PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/27532042 microcirculation dysfunction in the liver lobules and kidney tubules at 6 hours after sepsis challenge, and such findings were similar between groups, but after 24 hours the survivors showed an improved microcirculation hemodynamic pattern and it was more evident in the S8 group. The survivals of the S8 E30 minute treated group showed less injury at 6 hours and 24 hours as compared with nontreated groups and S8 L6 hour treated animals. In S9 treated groups, both showed a partial repair at 24 hours post sepsis. Conclusions: The hyperfluid therapy given rapidly in both early and late phases in sepsis and severe sepsis states showed that its beneficial effect was more or less effective dependent on the phase and sepsis intensity; however, the more prominent survival rates were seen at the early phase of sepsis (S8) and at the later phase of severe sepsis (S9). The underlying pathophysiology evolved in these paradoxical conditions needs to be better elucidated. Acknowledgements: Grant number 2012/20841-7, S Paulo Research Foundation (FAPESP).P70 Possible variables related to paradoxical findings between PCR and hemoculture assays in rat experimental sepsis Marcello R da Silva1*, Marcos M Caseiro2, Dercy Jos?de S?Filho2, Ivan HJ Koh3 1 Department of Pediatrics, Federal University of S Paulo, Brazil; 2 Department of Pediatrics, Lus da University Center, Lisbon, Portugal; 3 Department of Surgery, Federal University of S Paulo, Brazil Critical Care 2013, 17(Suppl 4):P70; doi:10.1186/cc12969 Background: A positive blood culture (BC) is considered the gold standard method for the sepsis diagnosis, although its sensibility is low (10 to 30 ) which demands a better diagnostic tool to limit broadspectrum anti.