Skin microcirculatory changes reflect early the circulatory deterioration in a fulminant sepsis model in the pig

Abstract

Intellectual and scientific content of the study, conception and design of the study, critical revision, final approval of the manuscript. ABSTRACT PURPOSE:In the pathophysiology of sepsis tissue perfusion dysfunction is a crucial driving force. Thus the early recognition is highly important. Concerning the early hours of bacteremia, and the systemic inflammatory response reaction leading to sepsis we aimed to investigate the micro-and macrocirculatory changes. METHODS:In 20 juvenile Hungahib pigs were anesthetized and the femoral artery and external jugular vein were prepared unilaterally and cannulated. For assisted ventilation tracheostomy was performed. In Sepsis group (n=11) live E. coli was intravenously administered (increasing concentration, 9.5x10^6 in 3h). In Control group (n=9) bacteria-free saline was administered at the same volume. Modified shock index (MSI), core and skin temperature, and skin microcirculation (laser Doppler) were measured before inducing bacteremia then hourly for 4h. RESULTS:In Control group parameters were stable, while six animals in the Sepsis group died before the 4 th hour. Core and skin temperature did not show significant alterations. In Sepsis group microcirculation showed a large impairment already by the 1st hour, while in MSI only by the 3rd hour. CONCLUSION:During bacteremia and the early phase of sepsis microcirculatory impairment can be detected soon, even hours before the deterioration in hemodynamic parameters in this porcine model.Key words: Bacteremia. Sepsis. Microcirculation. Hemodynamics. Shock. Models, Animal. Swine. Skin microcirculatory changes reflect early the circulatory deterioration in a fulminant sepsis model in the pig

Abdominal organ perfusion and inflammation in experimental sepsis: a magnetic resonance imaging study

“…We studied an endotoxemic porcine model characterized by a hypodynamic septic state. This is similar to other studies in endotoxemic pigs (20,23,44,52). A hyperdynamic state is the general finding in septic human patients (1), but decrease in cardiac output, has been detected in a considerable percentage of septic human cases (9,16).…”

Red blood cell and platelet parameters are sepsis predictors in an Escherichia coli induced lethal porcine model

“…In the E.coli-treated group, sepsis was induced by Escherichia coli suspension (2.5 × 10 5 /mL; strain: ATCC 25922, Department of Medical Microbiology, University of Debrecen), which was intravenously administered in a continuously increasing manner: 2 mL in the first 30 minutes, then 4 mL in 30 minutes and afterwards 16 mL/hour for 2 hours. A total amount of 9.5 × 10 6 E. coli was infused within 3 hours [8,9]. In the control group the similar volume of isotonic saline solution was administered by the same protocol as in the septic group and no other intervention was applied.…”

Hemodynamic consequences of intravenously given E. coli suspension: observations in a fulminant sepsis model in pigs, a descriptive case–control study

“…It seems that the inflammatory response that is evoked by E. coli infusion is directed toward the cardiac contractile function (both cardiac index and global ejection faction decreased during the process). As a consequence of this hypodynamic circulatory response, an immediate microcirculatory impairment was observed in an early phase of the bacterial injection [12], whereas cerebral autoregulation remained unaffected [13]. It has been also documented that due to this hemodynamic collapse, lactate levels got elevated followed by the increased appearance of nucleated red blood cells, indicating tissue hypoxia [14].…”