Cecal ligation and incision: an acute onset model of severe sepsis in rats.
BACKGROUND
Sepsis is a leading cause of death among critically ill patients. Up to now, severe sepsis with acute onset in animals has been induced mainly through injection of single bacteria species or endotoxin and not through a surgical procedure, which might adequately mirror the situation in septic patients. We therefore aimed to establish a surgical model of severe sepsis in rodents fulfilling international sepsis criteria.


METHODS
Twenty-eight anesthetized/ventilated Sprague Dawley rats underwent laparotomy and cecal mobilization. The cecum was either replaced into the abdomen (SHAM, n = 14) or the cecum and the mesenteric blood vessels were ligated, and the cecum was opened through a 1.5 cm blade incision (cecal ligation and incision, CLI, n = 14).


RESULTS
Within 390 min, mortality was 0% (SHAM) and 50% (CLI), respectively. Compared with SHAM, CLI resulted in a 43% reduction of mean arterial blood pressure and in severe metabolic acidosis as measured by arterial base excess and pH. CLI led to a 15-fold increase in mononuclear cell population and to a 5-fold accumulation of nitrite in peritoneal lavage. Abdominal swabs from the Douglas cavity in CLI-animals showed gram-positive and gram-negative bacterial growth on agar compared with sterile swabs from SHAM-animals. In CLI-animals, plasma IL-1beta level was increased to 435 pg/mL (SHAM: 10 pg/mL) and plasma IL-6 level to 19718 pg/mL (SHAM: 832 pg/mL).


CONCLUSIONS
CLI causes bacterial peritonitis with subsequent systemic inflammation and organ dysfunction. Thus, CLI mimics clinical sepsis and provides a surgical short term model of severe sepsis in rodents.
Scheiermann
Patrick
P
Department of Anesthesiology, Intensive Care Medicine, and Pain Therapy, Hospital of the Johann Wolfgang Goethe-University, Frankfurt/Main, Germany. pscheiermann@gmail.com
Hoegl
Sandra
S
Revermann
Marc
M
Ahluwalia
Devan
D
Zander
Johannes
J
Boost
Kim A
KA
Nguyen
Thach
T
Zwissler
Bernhard
B
Muhl
Heiko
H
Hofstetter
Christian
C
D000138:Acidosis / Q000503:physiopathology; D000208:Acute Disease; D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D001831:Body Temperature / Q000502:physiology; D002432:Cecum / Q000601:surgery*; D004195:Disease Models, Animal; D006339:Heart Rate / Q000502:physiology; D006863:Hydrogen-Ion Concentration; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008026:Ligation; D008297:Male; D010537:Peritoneum / Q000382:microbiology; D010538:Peritonitis / Q000382:microbiology* / Q000503:physiopathology; D051381:Rats; D017207:Rats, Sprague-Dawley; D018805:Sepsis / Q000382:microbiology* / Q000503:physiopathology; D013990:Tidal Volume / Q000502:physiology
D053583:Interleukin-1beta; D015850:Interleukin-6