Background
Therapeutic hypothermia in severe septic shock is associated with prolonged survival. We hypothesized that moderate hypothermia would prolong survival and modulate the inflammatory response in rats with septic shock by exerting its therapeutic effect on splenic leukocytes.
Materials and Methods
Severe septic shock was created in rats by cecal ligation and incision (CLI). One hour after CLI or laparotomy, rats were randomized to sham, normothermia (NT), or 4 hours of hypothermia (HT) followed by 2 hours of rewarming. Hypothermia (3l±1°C) was induced using a cooling blanket, and monitored via a rectal temperature probe.
Results
Survival duration was 2.78±1.0 hours in NT rats and 8.33±0.32 hours in HT rats (n=8/group, p<0.0001). In separate groups, three hours after CLI, the spleen weight was significantly smaller in NT rats (769±100 mg) than in HT rats (947±157 mg, p=0.04). Fluorescent immunostaining of formyl peptide receptors (FPR) on leukocytes in spleen tissue showed considerably higher FPR expression in HT rats than in NT rats. Significantly elevated pro-inflammatory cytokines and myeloperoxidase (MPO) enzyme in plasma were found in NT rats compared with HT rats. Anti-inflammatory cytokine, IL-10, was significantly higher in HT rats. Both pro-inflammatory cytokines and plasma MPO were significantly reduced in splenectomized NT rats.
Conclusions
Moderate hypothermic therapy significantly prolongs the survival duration of rats with severe septic shock. Hypothermia dampens the inflammatory response during septic shock by modulating the spleen to an anti-inflammatory mode and preventing the spleen from releasing activated splenic leukocytes into the blood.