The CRISMA (Clinical Research, Investigation, and Systems Modeling of Acute Illness) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
J Surg Res. 2013 Dec;185(2):790-6. doi: 10.1016/j.jss.2013.07.020. Epub 2013 Aug 6.
Unlike pharmacologic interventions in sepsis, extracorporeal blood purification, which is widely used in septic patients, is not typically studied in experimental rodents. Most of the previous studies have performed extracorporeal blood purification in larger animals and typically use arteriovenous (AV) vascular access. We developed a venovenous (VV) purification model in the rat as an adjunct for the treatment of sepsis.
Using adult male Sprague-Dawley rats, we cannulated the femoral artery or vein and the jugular vein with P50 tubing and created an AV or VV circuit. Blood flow was maintained by arterial pressure in the AV circuit, whereas in the VV circuit the blood flow was regulated using a rotary pump. The safety of this circuit was evaluated using the changes of blood interleukin 6, rectal temperature, and 7-d survival with sham extracorporeal circulation (circuit connection without treatment) compared with the control (without circuit). The main side complications of this VV circuit were compared with those of the AV circuit.
The differences in interleukin 6, body temperature, and cumulative survival were not statistically significant after extracorporeal circulation. The main complications of extracorporeal circulation occurred less often with VV compared with AV therapy: massive bleeding (2.5% versus 15%, P = 0.04); clot formation (2.5% versus 15%, P = 0.04). This VV circuit has been successfully used in different septic rodent models with different techniques (hemoadsorption and hemofiltration).
VV blood purification in a rodent model appears to be effective and is safer than AV circuit.
与脓毒症的药物干预不同,体外血液净化在脓毒症患者中广泛应用,但在实验性啮齿动物中通常不进行研究。以前的大多数研究都是在较大的动物中进行体外血液净化,并且通常使用动静脉(AV)血管通路。我们在大鼠中开发了一种静脉-静脉(VV)净化模型,作为脓毒症治疗的辅助手段。
使用成年雄性 Sprague-Dawley 大鼠,我们用 P50 管对股动脉或股静脉和颈静脉进行插管,并建立 AV 或 VV 回路。AV 回路中的血流由动脉压维持,而在 VV 回路中,使用旋转泵调节血流。通过与假体外循环(无治疗的回路连接)相比,评估 sham extracorporeal circulation (circuit connection without treatment)对血液白细胞介素 6、直肠温度和 7 天存活率的变化,评估该回路的安全性。与 AV 回路相比,比较了该 VV 回路的主要侧并发症。
体外循环后白细胞介素 6、体温和累积存活率的差异无统计学意义。与 AV 治疗相比,体外循环的主要并发症在 VV 中发生较少:大出血(2.5%比 15%,P = 0.04);凝块形成(2.5%比 15%,P = 0.04)。该 VV 回路已成功用于不同脓毒症啮齿动物模型中,采用不同技术(血液吸附和血液滤过)。
在啮齿动物模型中,VV 血液净化似乎是有效且比 AV 回路更安全。