Metabolic Effects of Experimental Bacteremia

Abstract

Hemodynamic and metabolic effects of a lethal 5-hour infusion of Ps. aeruginosa at a dose of 10⁸ organisms per ml per min were studied in 39 dogs. Blood glucose, insulin, catecholamines, body temperature, WBC, and hemodynamic parameters were measured before and at 1-hour intervals during controlled bacterial infusions. Induced bacteremia in the upper 10⁴ range per ml of blood was accompanied by a decline of mean arterial blood pressure from 130 ± 6 mm Hg to 84 ± 12 mm Hg at 4 hours, hypothermia, leukopenia, and hypoglycemia. Death within 24 hours was associated with hypoinsulinemia and increased blood catecholamines. Survival was characterized by maintenance of arterial blood pressure, only moderate decline in blood glucose levels, and normal plasma insulin concentrations with little change in plasma catecholamines. Mortality could be reduced significantly by glucose administration. This was associated with correction of hypoglycemia, rise in plasma insulin activity and increased energy production.