Zsikai Bettina, Bizánc Lajos, Sztányi Péter, Vida Gergely, Nagy Enikő, Jiga Lucian, Ionac Mihai, Erces Dániel, Boros Mihály, Kaszaki József
Szegedi Tudományegyetem, Általános Orvostudományi Kar Sebészeti Műtéttani Intézet 6720 Szeged Pécsi u. 6.
Magy Seb. 2012 Aug;65(4):198-204. doi: 10.1556/MaSeb.65.2012.4.5.
Our aim was to develop a large animal model of sepsis induced by fecal peritonitis, which reproduces the characteristic macrohemodynamic, microcirculatory and inflammatory changes seen in human sepsis.
Anesthetized minipigs were subjected to fecal peritonitis (n = 9; 0.5 g/kg i.p. autofeces) or sham-operation (i.p. saline, n = 6). Invasive hemodynamic monitoring was started with regular blood gas analyses between the 15-24 hr of the insult. Sublingual microcirculation was characterized by red blood cell velocity changes (with orthogonal polarization spectral imaging), and the extravascular lung water index (EVLWI) was measured. The plasma levels of big-endothelin (big-ET) and high-mobility group box protein-1 (HMGB1) were determined from venous blood samples.
The mean arterial pressure gradually decreased below 70 mmHg in septic animals, while the heart rate and cardiac output increased constantly. In spite of the hyperdynamic reaction, significant elevation of the EVLWI was observed, while the sublingual microcirculation deteriorated, as compared with the control group. The big-ET and HMGB1 plasma concentrations were significantly elevated between 6-24 hr of peritonitis.
The in vivo data suggest that our fecal peritonitis-induced experimental sepsis model is of clinical relevance, and may play useful roles in the development of novel, sepsis-related therapies.
我们的目标是建立一种由粪性腹膜炎诱导的大型动物脓毒症模型,该模型能够再现人类脓毒症中特征性的宏观血流动力学、微循环和炎症变化。
对麻醉后的小型猪进行粪性腹膜炎手术(n = 9;腹腔注射0.5 g/kg自体粪便)或假手术(腹腔注射生理盐水,n = 6)。在损伤后15 - 24小时之间开始进行有创血流动力学监测,并定期进行血气分析。通过红细胞速度变化(采用正交偏振光谱成像)来表征舌下微循环,并测量血管外肺水指数(EVLWI)。从静脉血样本中测定血浆中大分子内皮素(big - ET)和高迁移率族蛋白B1(HMGB1)的水平。
脓毒症动物的平均动脉压逐渐降至70 mmHg以下,而心率和心输出量持续增加。尽管存在高动力反应,但与对照组相比,仍观察到EVLWI显著升高,同时舌下微循环恶化。在腹膜炎发生后6 - 24小时之间,血浆中big - ET和HMGB1的浓度显著升高。
体内数据表明,我们的粪性腹膜炎诱导的实验性脓毒症模型具有临床相关性,可能在新型脓毒症相关治疗方法的开发中发挥有益作用。