Department of Emergency Medicine, Seoul Medical Center, 316 Sinnae-dong, Jungnang-gu, Seoul 131-130, Republic of Korea.
Cytokine. 2012 Dec;60(3):755-61. doi: 10.1016/j.cyto.2012.08.013. Epub 2012 Sep 11.
The effects of therapeutic hypothermia (HT) during experimental sepsis may be influenced by disease severity. We experimentally investigated the effect of therapeutic HT on varying disease severity in a septic rat model.
An adult male Sprague-Dawley rat model of intra-abdominal sepsis was used. To modify the disease severity, we used two different models; a moderate severe sepsis model (MSSM) and a severe septic shock model (SSSM). All rats were randomized to a hypothermia group (HT, 30-32°C) or a normothermia group (NT, 36-38°C) 1h after sepsis induction in each model. HT was maintained for 4h and rewarming was conducted for 2h. Survival time was recorded for up to 12h in the SSSM group and 24h in the MSSM group. Acute lung and liver injury, cytokine, and malondialdehyde (MDA) levels were investigated 7h after sepsis induction. Hemodynamic profiles were also evaluated.
In the SSSM, there were survival benefits and reduced acute lung and liver injury with therapeutic HT. Therapeutic HT was also associated with significantly reduced levels of plasma interleukin-6 and tissue malondialdehyde (MDA) levels in the liver and lung compared with the NT group in the SSSM. There was a tendency for the mean arterial pressure to be higher in the HT group compared to the NT group in the SSSM. In MSSM, however, there was no such beneficial effect.
In this rat model of severe septic shock, therapeutic HT showed beneficial effects. In contrast, therapeutic HT did not show protective effect in the moderate sepsis model.
治疗性低温（HT）在实验性脓毒症中的作用可能受疾病严重程度的影响。我们在脓毒症大鼠模型中实验性研究了治疗性 HT 对不同疾病严重程度的影响。
使用成年雄性 Sprague-Dawley 大鼠腹腔内脓毒症模型。为了改变疾病严重程度，我们使用了两种不同的模型；中度严重脓毒症模型（MSSM）和严重脓毒性休克模型（SSSM）。在每个模型中，所有大鼠在脓毒症诱导后 1 小时随机分为低温组（HT，30-32°C）或常温组（NT，36-38°C）。HT 维持 4 小时，复温 2 小时。在 SSSM 组中记录存活时间长达 12 小时，在 MSSM 组中记录 24 小时。在脓毒症诱导后 7 小时，研究急性肺和肝损伤、细胞因子和丙二醛（MDA）水平。还评估了血流动力学特征。
在 SSSM 中，治疗性 HT 具有生存获益和减轻急性肺和肝损伤的作用。与 NT 组相比，治疗性 HT 还与血浆白细胞介素-6 和组织 MDA 水平显著降低相关，与 SSSM 中的 NT 组相比，治疗性 HT 还与肺和肝中的 MDA 水平显著降低相关。与 NT 组相比，SSSM 中 HT 组的平均动脉压有升高的趋势。然而，在 MSSM 中，没有这种有益的效果。
在这种严重脓毒性休克大鼠模型中，治疗性 HT 显示出有益的效果。相比之下，治疗性 HT 在中度脓毒症模型中没有表现出保护作用。
