Effects of fluids on the liver microcirculation and cell free DNA in sepsis

Fluid resuscitation is a crucial therapy for sepsis. The release of DNA into the circulation in sepsis may predict mortality. Our objective was to determine if our fluids alter hepatic leukocyte recruitment or the levels of plasma cell free DNA (cfDNA). Cecal ligation and perforation (CLP) was used to induce sepsis in C57BL/6 mice, and compared to sham‐operated controls. Briefly, the cecum was ligated distally, punctured and returned post fecal extrusion. The right jugular vein was catheterized to deliver Seplyte L (SepL) and Seplyte H (SepH), and with or without albumin. Hepatic leukocyte recruitment was assessed by intravital microscopy and plasma cfDNA measured. CLP mice had higher leukocyte adhesion in sinusoidal and post‐sinusoidal venules compared to shams in all groups. Post‐sinusoidal adhesion was reduced in CLP mice given colloidal SepL and SepH vs. base solutions (13.6± 0.8 vs. 8.1±1.4 and 13.4±1.1 vs. 7.6 ± 0.6; p < 0.05). Six hrs post‐CLP, cfDNA was higher in septic mice when given SepL (9.2±0.3 vs. 4.9±0.5 μg/mL), SepH (8.6±1.4 vs. 4.9±0.4), SepL albumin (9.4±1.1 vs. 5.3±0.2) and SepH albumin (7.2±0.7 vs. 5.3±0.3) (p < 0.03). There was no difference in cfDNA between solutions. The addition of a colloid to fluids results in less systemic inflammation in early sepsis as measured by hepatic leukocyte recruitment. The production of cfDNA in early sepsis however is not altered by the presence of colloid.