Department of Veterinary Disease Biology, Faculty of Life Sciences, University of Copenhagen, Copenhagen, Denmark.
APMIS. 2012 Nov;120(11):909-21. doi: 10.1111/j.1600-0463.2012.02917.x. Epub 2012 May 15.
The human sequential organ failure assessment (SOFA) scoring system is used worldwide in intensive care units for assessing the extent of organ dysfunction/failure in patients with severe sepsis. An increasing number of septic cases are caused by Gram-positive bacteria as Staphylococcus aureus. The aim of the current study was to apply the human SOFA parameters in an awake, porcine model of severe S. aureus sepsis. Five pigs were inoculated intravenously with S. aureus and two control animals were sham-inoculated. Extensive clinical monitoring and sequential blood sampling was obtained and analysed for SOFA parameters. Dysfunction/failure was observed in the respiratory, haemostatic and hepatic system of all infected animals, together with initial cardiovascular dysfunction. The pulmonary system was the first to fail clinically, which corresponds with similar human findings, whereas the liver was affected earlier in pigs compared to humans. The use of human SOFA parameters was valuable in identifying dysfunctional/failing organs and showed consistency between this porcine model and human severe sepsis. Applying SOFA parameters in this model increased the relevance for comparison to clinical methods of evaluating human severe sepsis. Changes in SOFA parameters may in future porcine studies serve as a target for monitoring the effect of therapeutic intervention.
人类序贯器官衰竭评估 (SOFA) 评分系统在全球重症监护病房中用于评估严重脓毒症患者的器官功能/衰竭程度。越来越多的脓毒症病例是由革兰氏阳性菌引起的,如金黄色葡萄球菌。本研究旨在将人类 SOFA 参数应用于清醒的、严重金黄色葡萄球菌脓毒症的猪模型中。将金黄色葡萄球菌静脉接种于五头猪,将两只对照动物假接种。进行了广泛的临床监测和序贯采血,并对 SOFA 参数进行了分析。所有感染动物均出现呼吸、止血和肝脏系统功能障碍/衰竭,以及初始心血管功能障碍。肺部系统是第一个出现临床功能障碍的系统,这与类似的人类发现一致,而与人类相比,猪的肝脏更早受到影响。使用人类 SOFA 参数有助于识别功能障碍/衰竭的器官,并显示该猪模型与人类严重脓毒症之间的一致性。在该模型中应用 SOFA 参数可提高与评估人类严重脓毒症的临床方法进行比较的相关性。SOFA 参数的变化可能会在未来的猪研究中作为监测治疗干预效果的目标。