Effects of ulinastatin on renal perfusion evaluated by Doppler ultrasonography in a porcine model of septic shock

Abstract Objective To develop a reliable and noninvasive method to evaluate the renal perfusion in a porcine model of septic shock and investigate the effect of UTI on it. Methods Thirty-two healthy male domestic pigs were randomly assigned to one of four groups: a sham group (SH, n=5); a septic shock group (SS, n=9); a septic shock group treated with vancomycin (15mg/kg) (VAN, n=9) and a septic shock group treated with UTI (50,000U/kg) + vancomycin (UTI, n= 9). Contrast-enhanced ultrasound (CEUS) of kidney at the baseline and the end of protocol (24h) were performed. The spectrum of interlobar or arcuate artery was selected to calculate the corrected resistive index (cRI). Sulphur hexafluoride (SF6) microbubbles were bolus injected via venous catheter. The peak intensity (Pi) and area under curve (AUC) were calculated by a time-intensity curve (TIC). Results cRI increased significantly at the end of the protocol except the SH groups, significant difference was found between each experimental group and the SH group. Linear regression was found between the cardiac output (CO) and Pi (Pi = 7.082 × CO + 5.026, R2=0.752, F=84.878, P < 0.001). The AUC decreased significantly post-injury in the SS and VAN group. All above parameters were improved by the UTI treatment, significant differences were found between the UTI and SS or VAN group respectively (P<0.05). Conclusions Septic shock occasionally accompanies with a significant low perfusion in renal microcirculation and UTI can improve it significantly.

Download Full-text

SOFA Score, Hemodynamics and Body Temperature Allow Early Discrimination between Porcine Peritonitis-Induced Sepsis and Peritonitis-Induced Septic Shock

Journal of Personalized Medicine ◽

10.3390/jpm11030164 ◽

2021 ◽

Vol 11 (3) ◽

pp. 164

Author(s):

Mahmoud Al-Obeidallah ◽

Dagmar Jarkovská ◽

Lenka Valešová ◽

Jan Horák ◽

Jan Jedlička ◽

...

Keyword(s):

Septic Shock ◽

Body Temperature ◽

Sofa Score ◽

Porcine Model ◽

Venous Blood ◽

Mixed Venous Blood ◽

Mechanically Ventilated ◽

Multiple Parameters ◽

Failure Assessment ◽

Sepsis And Septic Shock

Porcine model of peritonitis-induced sepsis is a well-established clinically relevant model of human disease. Interindividual variability of the response often complicates the interpretation of findings. To better understand the biological basis of the disease variability, the progression of the disease was compared between animals with sepsis and septic shock. Peritonitis was induced by inoculation of autologous feces in fifteen anesthetized, mechanically ventilated and surgically instrumented pigs and continued for 24 h. Cardiovascular and biochemical parameters were collected at baseline (just before peritonitis induction), 12 h, 18 h and 24 h (end of the experiment) after induction of peritonitis. Analysis of multiple parameters revealed the earliest significant differences between sepsis and septic shock groups in the sequential organ failure assessment (SOFA) score, systemic vascular resistance, partial pressure of oxygen in mixed venous blood and body temperature. Other significant functional differences developed later in the course of the disease. The data indicate that SOFA score, hemodynamical parameters and body temperature discriminate early between sepsis and septic shock in a clinically relevant porcine model. Early pronounced alterations of these parameters may herald a progression of the disease toward irreversible septic shock.

Download Full-text