A porcine model of sepsis resulting from the combined insults of hemorrhage and peritonitis.
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.
Parker
S J
SJ
Biomedical Sciences, DERA Porton Down, Salisbury, Wiltshire, UK.
Hill
P F
PF
Brown
D
D
Kenward
C E
CE
Watkins
P E
PE
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
D004731:Endotoxins; D014409:Tumor Necrosis Factor-alpha