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在内毒素血症猪模型中,肝脏作为氧合受损和细胞因子产生的焦点。

Liver as a focus of impaired oxygenation and cytokine production in a porcine model of endotoxicosis.

作者信息

Bathe O F, Rudston-Brown B, Chow A W, Phang P T

机构信息

Department of Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.

出版信息

Crit Care Med. 1998 Oct;26(10):1698-706. doi: 10.1097/00003246-199810000-00025.

Abstract

OBJECTIVES

To determine whether the liver is a focus of insufficient oxygenation and whether liver is a source of tumor necrosis factor (TNF) and interleukin-6 (IL-6) in a porcine model of endotoxicosis.

DESIGN

In vivo, prospective, controlled, repeated-measures, experimental study.

SETTING

Experimental physiology laboratory in a university.

SUBJECTS

Juvenile pigs, weighing 22 to 35 kg.

INTERVENTIONS

Catheters for blood sampling were inserted into the carotid artery, portal vein, hepatic vein, and pulmonary artery of anesthetized animals. Ultrasonic flow probes were placed on the portal vein and the hepatic artery. During surgery, normal saline was infused intravenously at 25 mL/kg/hr. Following stabilization, animals were allocated randomly to one of two groups. The endotoxemic group (n = 6) received 50 mg/kg of purified Escherichia coli lipopolysaccharide infused into the external jugular vein over 1 hr. The control group (n = 6) received a sham saline infusion infused over 1 hr. Once the endotoxin or sham infusion was initiated, the rate of the intravenous saline infusion was increased to 48 mL/kg/hr for the remainder of the experiment. Measurements were obtained before the endotoxin or sham infusion, immediately after the infusion, and every 30 mins thereafter for 4 hrs.

MEASUREMENTS AND MAIN RESULTS

Blood gases, lactate, and bioactive TNF and IL-6 concentrations were measured from the carotid artery, portal vein, hepatic vein, and pulmonary artery. The porcine model is characterized by systemic hypotension, pulmonary hypertension, and maintenance of cardiac output. Despite decreased hepatic oxygen delivery in endotoxemic animals (p < .02), there was no change in hepatic oxygen consumption compared with controls. Throughout the experiment, there was net hepatic consumption of lactate in both groups. There was no significant hepatic production (or consumption) of TNF or IL-6 in either group.

CONCLUSIONS

In this porcine model of endotoxicosis, there is a reduction of hepatic oxygen delivery but dysoxia is not present. The liver is not a source of TNF or IL-6 in this model of endotoxicosis.

摘要

目的

在猪内毒素血症模型中,确定肝脏是否为氧合不足的部位,以及肝脏是否为肿瘤坏死因子(TNF)和白细胞介素-6(IL-6)的来源。

设计

体内前瞻性对照重复测量实验研究。

地点

一所大学的实验生理学实验室。

对象

体重22至35千克的幼年猪。

干预措施

将用于采血的导管插入麻醉动物的颈动脉、门静脉、肝静脉和肺动脉。将超声流量探头置于门静脉和肝动脉上。手术期间,以25毫升/千克/小时的速度静脉输注生理盐水。稳定后,将动物随机分为两组。内毒素血症组(n = 6)在1小时内通过颈外静脉输注50毫克/千克的纯化大肠杆菌脂多糖。对照组(n = 6)接受1小时的假生理盐水输注。一旦开始内毒素或假输注,在实验剩余时间内将静脉生理盐水输注速度提高到48毫升/千克/小时。在内毒素或假输注前、输注后立即以及此后每30分钟测量一次,共测量4小时。

测量指标及主要结果

从颈动脉、门静脉、肝静脉和肺动脉测量血气、乳酸以及生物活性TNF和IL-6浓度。猪模型的特征为全身性低血压、肺动脉高压和心输出量维持。尽管内毒素血症动物的肝脏氧输送减少(p < 0.02),但与对照组相比,肝脏氧消耗没有变化。在整个实验过程中,两组肝脏均有乳酸净消耗。两组均无明显的肝脏TNF或IL-6产生(或消耗)。

结论

在这个猪内毒素血症模型中,肝脏氧输送减少,但不存在氧障碍。在这个内毒素血症模型中,肝脏不是TNF或IL-6的来源。

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