Open AccessTwo‐hit model of haemorrhagic shock and Pseudomonas sepsis
Author(s) -
Eissner B.,
von Engelhardt K.,
Röschmann A.,
Ungelenk B.,
Mertens A.,
Wudke J.,
Smorodschenko A.,
Valerio M.,
Hahn H.,
von Specht B. U.,
Haberstroh J.
Publication year - 2000
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1046/j.1365-2168.2000.01544-75.x
Subject(s) - medicine , sepsis , resuscitation , shock (circulatory) , septic shock , pseudomonas aeruginosa , vascular resistance , haemorrhagic shock , anesthesia , blood pressure , mean arterial pressure , cardiac index , blood volume , cardiac output , hemodynamics , heart rate , biology , bacteria , genetics
Background Shock or trauma is a frequent prerequisite of bacterial sepsis. This has not, however, been reported in connection with related animal models. Therefore a porcine two‐hit model was established with haemorrhage and resuscitation followed by the induction of sepsis with Pseudomonas aeruginosa . Methods Thirteen pigs were anaesthetized and permanently catheterized. Seven were subjected to haemorrhagic shock (bleeding until a mean of 50 per cent of the estimated blood volume remained) for 45 min, and then resuscitated with crystalloid, colloid and shed blood. A further six animals without shock served as controls. All pigs were fully conscious. The following day a continuous intravenous infusion of P. aeruginosa (1·6 × 10 7 colony‐forming units kg −1 h −1 ) was given for 24 h, followed by a reduced dose (1·6 × 10 6 colony‐forming units kg −1 h −1 ) for a further 24 h. The animals were then observed for another 48 h. Results All animals fulfilled the criteria for sepsis. However, the initial fever, arterial pressure and systemic vascular resistance were significantly lower in the shock group. In contrast, the pulmonary pressure, pulmonary vascular resistance and cardiac index were raised ( P < 0·05, shock versus control group). Conclusion These data indicate that sepsis is aggravated by a preceding haemorrhagic shock. This two‐hit model considers one important precondition of human sepsis and may contribute to the development of a better treatment for this condition. © 2000 British Journal of Surgery Society Ltd