[Septic shock and multiple organ failure in surgical intensive care. An animal experiment model on the analysis of pulmonary and intestinal dysfunction].
The study deals with an animal model for the problems of surgical intensive care patients. Following repeated applications of E. coli endotoxin WO 111:B4 under standard conditions, specific hemodynamic and biochemical (TNF, TXA2, PGI2, IL-6, PAF) and morphological (endothelium of the lung) alterations were detected. ARDS patterns induced by the sepsis were analyzed by high-frequency measurement of pressure and flow (385 measurements per breathing cycle). The role of the intestine in sepsis was investigated by ion-selective monitoring of surface potassium activity comparing mucosa and serosa. Every injection of endotoxin was followed by a selective increase of the potassium activity revealing relative ischemia induced by the endotoxin. The profile of the potassium levels on the surface correlates both with the cardiac output and with the prostacyclin levels. The continuous narrowing of the difference between mucosa and serosa, potassium during the period of investigation can be regarded as evidence for pathologic change in permeability fostering the septic course.
Töns
C
C
Chirurgische Klinik, RWTH Aachen.
Klosterhalfen
B
B
Klinge
U
U
Kirkpatrick
C J
CJ
Mittermayer
C
C
Schumpelick
V
V
D015121:6-Ketoprostaglandin F1 alpha / Q000097:blood; D000818:Animals; D003422:Critical Care; D011464:Epoprostenol / Q000097:blood; D004927:Escherichia coli Infections / Q000473:pathology / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology; D015850:Interleukin-6 / Q000097:blood; D007413:Intestinal Mucosa / Q000098:blood supply / Q000473:pathology; D007422:Intestines / Q000098:blood supply*; D007473:Ion Channels / Q000502:physiology; D007511:Ischemia / Q000473:pathology / Q000503:physiopathology*; D008168:Lung / Q000473:pathology; D008854:Microscopy, Electron; D009102:Multiple Organ Failure / Q000473:pathology / Q000503:physiopathology*; D010972:Platelet Activating Factor / Q000378:metabolism; D011183:Postoperative Complications / Q000473:pathology / Q000503:physiopathology*; D011188:Potassium / Q000378:metabolism; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012128:Respiratory Distress Syndrome / Q000473:pathology / Q000503:physiopathology*; D012772:Shock, Septic / Q000473:pathology / Q000503:physiopathology*; D013552:Swine; D013928:Thromboxane A2 / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D015850:Interleukin-6; D007473:Ion Channels; D010972:Platelet Activating Factor; D014409:Tumor Necrosis Factor-alpha; D013928:Thromboxane A2; D015121:6-Ketoprostaglandin F1 alpha; D011464:Epoprostenol; D011188:Potassium