Direct effects of insulin and endotoxin on glucose uptake by skeletal muscle during high cardiac index sepsis in the dog.

Experiments were completed upon unanesthetized and anesthetized dogs in the control and septic groups. Dogs that were made septic by the intraperitoneal administration of live Escherichia coli bacteria showed an elevation in cardiac index and core temperature and a decrease in total peripheral resistance index and mean arterial blood pressure. Following the seventh day of sepsis, the dogs were anesthetized and the constantly perfused gracilis muscle preparation was used for metabolic and hemodynamic determinations. Insulin stimulated muscle glucose uptake in non-septic dogs was markedly increased, whereas increases in muscle glucose uptake in the septic group of dogs was absent when challenged with local insulin infusion. Resting muscle glucose uptake of the septic group was observed to be greater than that of dogs in the nonseptic group. These data demonstrate a hyperdynamic model of sepsis in the dog which was associated with decreased muscle responsiveness or sensitivity to local insulin infusion, or both. The insulin-like activity of the endotoxin molecule in promoting muscle glucose uptake was maintained in both the septic and control group of dogs. This activity of the endotoxin molecule could explain, in part, the increased resting muscle glucose uptake observed in the septic group of dogs.