Article Text

  1. A. K. Markov1,
  2. E. T. Warren1,
  3. H. H.P. Cohly1,
  4. D. J. Sauls1,
  5. T. N. Skelton1
  1. 1University of Mississippi Medical Center, Jackson, MS


Introduction Fructose-1, 6-diphosphate (FDP) is reported to have a salutary effect in endotoxin shock and sepsis. This investigation describes the effect of FDP on pulmonary and systemic hemodynamics, lung lymph protein clearance, and leukocyte count in sheep infused with E. coli endotoxin.

Materials and Methods Anesthetized sheep (n = 18), some of which underwent thoracotomy to cannulate lymphatic nodes, were used in this study. Following stabilization, all sheep received E. coli endotoxin 5 μg/kg IV infusion over 30 minutes. Concomitant with the endotoxin infusion, half of the animals were randomly selected to receive an IV bolus of FDP (10%) 50 mg/kg followed by a continuous infusion of 5 mg/kg/min for 4 hours; the rest were treated in the same manner with glucose 10% in 0.9% NaCl.

Results Pulmonary artery pressure (PAP) and resistance in the glucose group increased from 20.8 ± 1.6 to 36.7 ± 3.2 mm Hg (p < .007) and from 531 ± 114 to 1,137 ± 80 dynes/s/cm−5, respectively (p < .005). Despite an increase during endotoxin infusion, these parameters in the FDP group returned to control values. There were no differences in left ventricular pressures, cardiac output, heart rate, and arterial oxygen tension between the groups. In the glucose group, lymph protein clearance was higher (p < .01) and blood leukocyte count was lower (p < .02). The wet/dry lung weight ratio (g/g) for the glucose group was 5.57 ± 0.04 and for the FDP-treated group 4.76 ± 0.06 (p < .0005).

Conclusion FDP treatment attenuated significantly the characteristic pulmonary hypertension, lung lymph protein clearance, and pulmonary vascular leakage seen in sheep infused with endotoxin.

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