title: A porcine model of sepsis resulting from the combined insults of hemorrhage and peritonitis.
abstract: The physiological responses to either hemorrhage or sepsis have been well documented, however, their simultaneous delivery, as often seen in penetrating trauma, has not been extensively studied. A terminally-anesthetized porcine model of fixed-volume hemorrhage combined with intraperitoneal sepsis was developed. Large White pigs (45-60 kg) were bled 40% of blood volume and peritonitis was induced using an E. coil (O18:K1:H7) culture. Three groups of animals were sequentially studied. Group A (n = 8) received 10(8) bacteria, and Groups B (n = 4) and C (n = 5) received 10(10) organisms. All animals were maintained on a 2.5 mL/kg/h infusion of 0.9% saline. Group C was autotransfused at 1 h. Animals were monitored for up to 24 h. Cardiovascular features of hypovolemia were recorded in all animals. Animals in Group A improved clinically with little microbiological evidence of systemic sepsis. Group B showed rapid cardiovascular collapse, early E. coil-positive blood cultures, and an early rise in serum TNF-alpha levels. Autotransfusion of Group C significantly improved cardiopulmonary parameters, acid-base status, and survival. A reproducible model of hemorrhage and peritonitis, appropriate for abdominal trauma, which allows investigation of resuscitative and pharmacological interventions has been characterized.
authors.affiliation: Biomedical Sciences, DERA Porton Down, Salisbury, Wiltshire, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Parker
authors.forename: P F
authors.initials: PF
authors.lastname: Hill
authors.forename: D
authors.initials: D
authors.lastname: Brown
authors.forename: C E
authors.initials: CE
authors.lastname: Kenward
authors.forename: P E
authors.initials: PE
authors.lastname: Watkins
mesh_terms: D000136:Acid-Base Equilibrium; D000818:Animals; D001794:Blood Pressure; D001804:Blood Transfusion, Autologous; D001810:Blood Volume; D004731:Endotoxins / Q000097:blood; D004927:Escherichia coli Infections / Q000150:complications*; D005260:Female; D006439:Hemodynamics; D006470:Hemorrhage / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D007249:Inflammation; D010538:Peritonitis / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D011652:Pulmonary Circulation; D018805:Sepsis / Q000209:etiology / Q000503:physiopathology*; D016019:Survival Analysis; D013552:Swine; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D014655:Vascular Resistance
chemical_list: D004731:Endotoxins; D014409:Tumor Necrosis Factor-alpha