DOI: 10.12688/f1000research.181843.1 ISSN: 2046-1402

Hemodynamic Responses to Fluid and Vasopressor Resuscitation Strategies in Experimental Septic Shock: A Randomized Porcine Model Research Protocol

Aridamuriany Dwiputri Lubis, Muhammad Rusda, Antonius Hocky Pudjiadi, Inke Nadia Diniyanti Lubis, Gunanti Gunanti, Supriatmo Supriatmo, Siska Mayasari Lubis, Cut Meliza Zainumi, Hilma Putri Lubis, Andriandi Andriandi
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Introduction Septic shock is a condition resulting from an uncontrolled immune response to infection, leading to multi-organ failure. Fluid resuscitation is the primary initial therapy, but an aggressive approach risks fluid overload and increased extravascular lung water (EVLW). To date, direct comparative evidence between fluid-based resuscitation strategies, vasopressors, or a combination of both on hemodynamic changes is limited. This study aims to evaluate the differences in hemodynamic responses of these three strategies using the Sus scrofa domestica animal model. Methods This experimental study, conducted at the Veterinary Teaching Hospital of IPB University from November 2024 to January 2025, comprised 15 male Sus scrofa domestica, aged 16–20 weeks, weighing 40–60 kg, plus three controls. Randomization was performed using Random.org with allocation concealment, and procedures were standardized to minimize confounding. Septic shock was induced using lipopolysaccharide (E. coli O111:B4) until a MAP of <65 mmHg was achieved. Subjects were then divided into three groups: fluid-first, vasopressor-first, and combined. The primary parameters assessed included achieving a MAP of ≥65 mmHg, hemodynamic parameters (MAP, CI, SVRI, SVI, GEDVI, ELWI), laboratory biomarkers, and oxygen transport parameters (DO₂ and CaO₂). Statistical analyses were performed according to the data distribution with a significance level of p < 0.05. This study is expected to provide mechanistic understanding of the interaction between intravascular volume, vascular tone, and tissue perfusion in septic shock. Anticipated limitations include intersubject variation in intravascular volume and a relatively small sample size. Conclusion The findings are expected to improve understanding of the physiological interplay between fluid resuscitation and vasopressor support in septic shock.

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