Hinojosa-Gonzalez David, Kottooran Christina, Saunders Jennifer, Chaussee Erin L, Budrewicz Jay, Eisner Brian H
Department of Urology, Massachusetts General Hospital, Boston, MA, USA.
Boston Scientific Corporation, Marlborough, MA, USA.
BJU Int. 2025 Feb;135(2):279-285. doi: 10.1111/bju.16539. Epub 2024 Oct 24.
To evaluate the relationship between renal pelvis pressure and infection after ureteroscopy, using a live swine model.
In anaesthetised pigs, a 1-h ureteroscopy was performed using a pressure-sensing guidewire, with renal pelvis pressure maintained at either 37 mmHg or 75 mmHg for the entire procedure and infusion with saline alone or with a standardised concentration of uropathogenic Escherichia coli strain CFT073 (1.5 × 10 colony-forming units [CFU]/mL). Venous blood sampling was performed during and after the procedure. Vital signs, inflammatory biomarkers, and renal tissue and blood cultures were assessed.
In 21 pig kidneys, study groups were: 37 mmHg with saline irrigation (n = 3); 75 mmHg with saline irrigation (n = 4); 37 mmHg with saline irrigation with 1.5 × 10 CFU/mL E. coli (n = 7); and 75 mmHg with saline irrigation with 1.5 × 10 CFU/mL E. coli (n = 7). Statistically significant changes in inflammatory biomarkers were most pronounced in the group with 75 mmHg saline irrigation + E. coli and were significantly elevated compared with the control group and the group receiving E. coli irrigation at 37 mmHg. Positive blood cultures were noted in 5/7 animals treated with E. coli at 75 mmHg; no others developed bacteraemia.
In this swine model of ureteroscopy, irrigation with saline + E. coli at a renal pelvis pressure of 75 mmHg resulted in bacteraemia and inflammatory biomarker elevations significantly greater than both E. coli irrigation with renal pelvis pressure maintained at 37 mmHg and the control.
使用活体猪模型评估输尿管镜检查后肾盂压力与感染之间的关系。
对麻醉后的猪，使用压力传感导丝进行1小时的输尿管镜检查，在整个过程中将肾盂压力维持在37 mmHg或75 mmHg，并单独输注生理盐水或输注标准化浓度的尿路致病性大肠杆菌菌株CFT073（1.5×10菌落形成单位[CFU]/mL）。在手术期间和手术后进行静脉血采样。评估生命体征、炎症生物标志物以及肾组织和血培养。
在21个猪肾中，研究组包括：37 mmHg生理盐水冲洗（n = 3）；75 mmHg生理盐水冲洗（n = 4）；37 mmHg生理盐水冲洗加1.5×10 CFU/mL大肠杆菌（n = 7）；以及75 mmHg生理盐水冲洗加1.5×10 CFU/mL大肠杆菌（n = 7）。炎症生物标志物的统计学显著变化在75 mmHg生理盐水冲洗+大肠杆菌组中最为明显，与对照组和37 mmHg大肠杆菌冲洗组相比显著升高。75 mmHg大肠杆菌处理的7只动物中有5只血培养呈阳性；其他动物均未发生菌血症。
在这个输尿管镜检查的猪模型中，肾盂压力为75 mmHg时用生理盐水+大肠杆菌冲洗导致菌血症和炎症生物标志物升高，显著大于肾盂压力维持在37 mmHg时的大肠杆菌冲洗和对照组。
