Rudiger Alain, Jeger Victor, Arrigo Mattia, Schaer Christian A, Hildenbrand Florian F, Arras Margarete, Seifert Burkhardt, Singer Mervyn, Schoedon Gabriele, Spahn Donat R, Bettex Dominique
Institute of Anesthesiology, University and University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Inflammation Research Unit, Division of Internal Medicine, University and University Hospital Zurich, Raemistrasse 100, CH 8091, Zurich, Switzerland.
Intensive Care Med Exp. 2018 Aug 20;6(1):28. doi: 10.1186/s40635-018-0190-5.
In sepsis, early outcome prediction would allow investigation of both adaptive mechanisms underlying survival and maladaptive mechanisms resulting in death. The aim of this study was to test whether early changes in heart rate monitored by telemetry could predict outcome in a long-term rat model of fecal peritonitis.
Male Wistar rats (n = 24) were instrumented with a central venous line for administration of fluids, antibiotics and analgesics. A telemetry transmitter continuously collected electrocardiogram signals. Sepsis was induced by intraperitoneal injection of fecal slurry, and the animals were observed for 48 h. Additional animals underwent arterial cannulation at baseline (n = 9), 4 h (n = 16), or 24 h (n = 6) for physiology and laboratory measurements.
48-h mortality was 33% (8/24), with all deaths occurring between 4 and 22 h. Septic animals were characterized by lethargy, fever, tachycardia, positive blood cultures, and elevated cytokine (IL-1, IL-6, TNF alpha) levels. An increase in heart rate ≥ 50 bpm during the first 4 h of sepsis predicted death with sensitivity and specificity of 88% (p = 0.001).
In this long-term rat sepsis model, prognostication could be made early by telemetry-monitored changes in heart rate. This model enables the study of underlying mechanisms and the assessment of any differential effects of novel therapies in predicted survivors or non-survivors.
在脓毒症中，早期预后预测有助于研究生存背后的适应性机制以及导致死亡的适应不良机制。本研究的目的是测试通过遥测监测的心率早期变化能否预测长期粪性腹膜炎大鼠模型的预后。
雄性Wistar大鼠（n = 24）植入中心静脉导管，用于输注液体、抗生素和镇痛药。遥测发射器持续收集心电图信号。通过腹腔注射粪便悬液诱导脓毒症，并对动物观察48小时。另外的动物在基线（n = 9）、4小时（n = 16）或24小时（n = 6）进行动脉插管，以进行生理学和实验室测量。
48小时死亡率为33%（8/24），所有死亡均发生在4至22小时之间。脓毒症动物的特征为嗜睡、发热、心动过速、血培养阳性以及细胞因子（IL-1、IL-6、TNF-α）水平升高。脓毒症最初4小时内心率增加≥50次/分钟可预测死亡，敏感性和特异性为88%（p = 0.001）。
在这个长期大鼠脓毒症模型中，通过遥测监测的心率变化可早期进行预后预测。该模型能够研究潜在机制，并评估新疗法对预测的存活者或非存活者的任何差异效应。
