Scheiermann Patrick, Hoegl Sandra, Revermann Marc, Ahluwalia Devan, Zander Johannes, Boost Kim A, Nguyen Thach, Zwissler Bernhard, Muhl Heiko, Hofstetter Christian
Department of Anesthesiology, Intensive Care Medicine, and Pain Therapy, Hospital of the Johann Wolfgang Goethe-University, Frankfurt/Main, Germany.
J Surg Res. 2009 Jan;151(1):132-7. doi: 10.1016/j.jss.2008.02.032. Epub 2008 Mar 18.
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.
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).
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).
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.
脓毒症是危重症患者死亡的主要原因。到目前为止，动物急性发作的严重脓毒症主要通过注射单一菌种或内毒素诱导产生，而非通过手术操作，而手术操作可能更能充分反映脓毒症患者的情况。因此，我们旨在建立一种符合国际脓毒症标准的啮齿动物严重脓毒症手术模型。
28只麻醉通气的Sprague Dawley大鼠接受剖腹术和盲肠游离术。盲肠要么放回腹腔（假手术组，n = 14），要么结扎盲肠和肠系膜血管，并通过1.5厘米的刀片切口切开盲肠（盲肠结扎和切开术，CLI，n = 14）。
在390分钟内，死亡率分别为0%（假手术组）和50%（CLI组）。与假手术组相比，CLI组导致平均动脉血压降低43%，并出现严重代谢性酸中毒，通过动脉碱剩余和pH值测量。CLI组导致单核细胞数量增加15倍，腹腔灌洗中亚硝酸盐积累增加5倍。与假手术组动物的无菌拭子相比，CLI组动物Douglas腔的腹部拭子在琼脂上显示革兰氏阳性和革兰氏阴性细菌生长。在CLI组动物中，血浆白细胞介素-1β水平升至435 pg/mL（假手术组：10 pg/mL），血浆白细胞介素-6水平升至19718 pg/mL（假手术组：832 pg/mL）。
CLI导致细菌性腹膜炎，随后出现全身炎症和器官功能障碍。因此，CLI模拟临床脓毒症，并提供了一种啮齿动物严重脓毒症的手术短期模型。
