PENTOXIFYLLINE AND OXYGEN-CONSUMPTION IN SEVERE SEPSIS - A PRELIMINARY-REPORT

Objective: To demonstrate that pentoxifylline (PTX) and not placebo improves oxygen consumption (VoverdotO(2)) in critically ill patients with severe sepsis. Setting: Multidisciplinary intensive care unit in a university affiliated hospital. Design: A randomized, double blinded clinical trial comparing 300 mg of PTX administered in a 120 min iv infusion with an identically looking placebo. Patients: 13 patients (9 men and 4 women) average age 39 (24-62) years old received PTX, and 12 patients (5 men and 7 women) average age 38 (21-83) years old received placebo. All satisfied ACCP/SCCM criteria for severe sepsis. Measurements and interventions: Patients fulfilling criteria for severe sepsis were identified on admission, cardiac output, DoverdotO(2), and Voverdot(2) were measured by thermodilution and standard oximetric technics after adequate volume replacement at baseline, 60 and 120 during infusion. F-test of analysis of variance was used to test hypothesis about differences of Doverdot(2) and Voverdot(2) by group, by time and for the interaction terms, a ''p'' value <0.05 was considered significant. Results: Evaluation of baseline measurements of both groups revealed no significant difference in any haemodynamic function or oxygen transport variables. The average VoverdotO(2) difference (0-120 min) between groups was 21 ml/min . m(2) and it was higher in the experimental group, however, this difference was non significant. Conclusion: We think that the trend in VoverdotO(2) followed by the experimental group is clinically important. If this difference is sustained we will probably be able to demonstrate our hypothesis.