Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
J Surg Res. 2019 Dec;244:492-501. doi: 10.1016/j.jss.2019.06.094. Epub 2019 Jul 19.
Although there are well-established small-animal sepsis models, the longitudinal assessment of hemodynamic variables, laboratory values, and blood culture in a single living sepsis model is limited. Therefore, we aimed to comprehensively characterize fecal peritonitis-induced sepsis in a porcine model.
Autologous feces (1 g/kg) was administered into the peritoneum of 11 male pigs (49 ± 8 kg). The pigs were monitored up to 12 h with full fluid and vasopressor support to maintain the mean arterial pressure at >65 mm Hg. Longitudinal blood culture and laboratory values were obtained at defined time intervals. The cytokine levels in plasma were analyzed. Furthermore, a clinical registry of sepsis patients at a single emergency department was used to compare the Sepsis-related Organ Failure Assessment scores with those of the porcine model.
The hyperdynamic phase of increasing cardiac output with decreasing systemic vascular resistance was maintained until 2 h, followed by the reverse (hypodynamic phase). With the escalating requirement for fluid and vasopressor, the lactate level progressively increased while the platelet count, urine output, and serum albumin level consistently decreased. Bacteremia developed 7 h (median) after the administration of feces, and Escherichia coli was the most common pathogen. The pattern of Sepsis-related Organ Failure Assessment scores with prominent cardiovascular failure was comparable to clinical data.
We implemented a porcine fecal peritonitis-induced sepsis model that demonstrates culture-proven bacteremia and multiple organ failure, particularly cardiovascular system failure. This model could facilitate the development of technologies for the early diagnosis of bacterial pathogens in blood.
虽然已经有成熟的小动物败血症模型，但在单个活体败血症模型中对血流动力学变量、实验室值和血培养进行纵向评估是有限的。因此，我们旨在全面描述猪粪腹膜炎诱导的败血症模型。
将 1 克/千克的自体粪便注入 11 头雄性猪（49±8 千克）的腹膜腔。猪被监测长达 12 小时，进行充分的液体和血管加压支持，以维持平均动脉压>65 毫米汞柱。在规定的时间间隔内获取纵向血培养和实验室值。分析血浆中的细胞因子水平。此外，还使用单个急诊部门的败血症患者临床登记册来比较败血症相关器官衰竭评估评分与猪模型的评分。
心输出量增加、全身血管阻力降低的高动力期持续至 2 小时，随后出现相反（低动力期）。随着对液体和血管加压剂需求的增加，乳酸水平逐渐升高，而血小板计数、尿量和血清白蛋白水平持续下降。粪便给药后 7 小时（中位数）出现菌血症，最常见的病原体是大肠杆菌。以心血管衰竭为主的败血症相关器官衰竭评估评分模式与临床数据相似。
我们实施了一种猪粪腹膜炎诱导的败血症模型，该模型显示出有培养证实的菌血症和多器官衰竭，特别是心血管系统衰竭。该模型可以促进早期诊断血液中细菌病原体的技术的发展。
