Fluid resuscitation in live Escherichia coli shock in puppies.

The infusion of live E. coli in the puppy produces a severe and usually lethal model of pediatric septic shock with characteristic reduction in cardiac output and blood pressure. Hemodynamic abnormalities are partially reversed with fluid resuscitation alone, and large volumes, supplemented with albumin well within tolerated fluid loads, produce the most pronounced corrections of these derrangements. Certain metabolic changes appear to be unique to the young animal and their correction is less successful regardless of resuscitation regimen. These findings suggest that the initial fluid management of the bacteremic pediatric patient should include Ringer's lactate and 5% albumin at approximately 105% of patient's blood volume. Further resuscitation fluid, as well as the role of steroids and antibiotics, remain work currently being carried out in our laboratory.