Murakami Kazunori, Bjertnaes Lars J, Schmalstieg Frank C, McGuire Roy, Cox Robert A, Hawkins Hal K, Herndon David N, Traber Lillian D, Traber Daniel L
Department of Anesthesiology, The University of Texas Medical Branch and Shriners Burns Hospital, Galveston, TX 77555, USA.
Crit Care Med. 2002 Sep;30(9):2083-90. doi: 10.1097/00003246-200209000-00022.
Patients with acute lung injury after smoke inhalation often develop pneumonia subsequently complicated by sepsis. This often is a fatal complication. The aim of this study was to develop a standardized and reproducible model of hyperdynamic sepsis after smoke inhalation in sheep.
Prospective, experimental study in sheep.
Experimental laboratory in a university hospital.
Twenty-one female Merino ewes.
Animals were anesthetized and surgically prepared for this chronic study. After a week of recovery, baseline data were collected. After tracheostomy was performed, sheep were connected to a volume-controlled ventilator. Acute lung injury was produced by insufflating the lungs with 48 breaths of cotton smoke. During halothane anesthesia, live bacteria suspended in a 30-mL saline solution containing 2-5 x 10(11) colony-forming units were instilled through a bronchoscope into the right lower and middle lung lobes (10 mL each) and left lower lung lobe (10 mL; n = 10). Eleven sheep were given smoke but not bacteria. After injury and the bacterial challenge, the animals were ventilated mechanically with 100% oxygen. The animals were monitored for 48 hrs. was detected in blood cultures after 14-48 hrs.
The sheep developed a hyperkinetic cardiovascular response concomitant with a decrease in Pao similar to severe sepsis in human patients who meet the criteria for acute respiratory distress syndrome (PaO2 /FIO2 <200). These changes were more severe than in animals exposed to smoke inhalation alone. Mean arterial pressures at 48 hrs in the smoke-alone and the smoke + sepsis group were 85.5 +/- 5.2 and 68.1 +/- 7.6 mm Hg, respectively (mean +/- se, p<.05).
This animal model closely resembles hyperdynamic sepsis in humans and may be of great value for studies of sepsis with smoke inhalation.
烟雾吸入后发生急性肺损伤的患者随后常并发肺炎,并进而发展为脓毒症。这通常是一种致命的并发症。本研究的目的是建立一种标准化且可重复的绵羊烟雾吸入后高动力型脓毒症模型。
对绵羊进行前瞻性实验研究。
大学医院的实验实验室。
21只雌性美利奴母羊。
对动物进行麻醉并为这项长期研究进行手术准备。恢复一周后,收集基线数据。进行气管切开术后,将绵羊连接到容量控制呼吸机上。通过向肺内吹入48次棉烟来造成急性肺损伤。在氟烷麻醉期间,将悬浮于含2 - 5×10¹¹菌落形成单位的30毫升盐溶液中的活细菌通过支气管镜注入右下和中叶肺叶(各10毫升)以及左下肺叶(10毫升;n = 10)。11只绵羊接受烟雾但未接受细菌。在损伤和细菌攻击后,动物用100%氧气进行机械通气。对动物监测48小时。在14 - 48小时后血培养中检测到(细菌)。
绵羊出现高动力型心血管反应,同时动脉血氧分压降低,类似于符合急性呼吸窘迫综合征标准(动脉血氧分压/吸入氧分数值<200)的人类严重脓毒症患者。这些变化比仅暴露于烟雾吸入的动物更严重。仅烟雾组和烟雾 + 脓毒症组在48小时时的平均动脉压分别为85.5±5.2和68.1±7.6毫米汞柱(平均值±标准误,p<0.05)。
该动物模型与人类高动力型脓毒症极为相似,可能对烟雾吸入性脓毒症的研究具有重要价值。