A porcine model of peritonitis and bacteremia simulates human septic shock.
Cardiovascular responses to systemic bacteremia were evaluated in a pre-instrumented, conscious pigs. Basal observations were obtained 5-7 days after instrumentation. On the next day, Escherichia coli 0111.B4 (1.1 to 33 x 10(9) CFU/kg)-laden fibrin clots were implanted intraperitoneally. Nonsurvivors (9/18) demonstrated rapid cardiovascular decompensation. Survivors (9/18) demonstrated significant cardiovascular injury, which was reversed by 5-7 days postimplant. Cardiac inotropicity was significantly reduced in this period, but recovered by day 7. Circulating myocardial depressant substance activity (assayed by serum-induced depression of beating neonatal rat myocytes) was present on days 1-4 of bacteremia and recovered to basal values on day 6. No clinical or cardiovascular changes were seen in pigs implanted with sterile clots (n = 4). These data demonstrate that implantation of bacteria-laden fibrin clots in pigs induces cardiovascular alterations that mimic responses seen in human sepsis.
Goldfarb
R D
RD
Section of Cardiology, Rush Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612, USA.
Glock
D
D
Kumar
A
A
McCarthy
R J
RJ
Mei
J
J
Guynn
T
T
Matushek
M
M
Trenholme
G
G
Parrillo
J E
JE
D000818:Animals; D016470:Bacteremia / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D001794:Blood Pressure; D002302:Cardiac Output; D002319:Cardiovascular System / Q000382:microbiology / Q000503:physiopathology; D002478:Cells, Cultured; D003326:Coronary Circulation; D004195:Disease Models, Animal; D004926:Escherichia coli / Q000472:pathogenicity; D005260:Female; D006339:Heart Rate; D009206:Myocardium / Q000166:cytology / Q000378:metabolism; D010538:Peritonitis / Q000150:complications / Q000503:physiopathology*; D051381:Rats; D012772:Shock, Septic / Q000503:physiopathology*; D015996:Survival Rate; D013552:Swine; D013997:Time Factors; D014180:Transplantation; D014655:Vascular Resistance