Characterization of Fecal Peritonitis–Induced Sepsis in a Porcine Model

I. Park, Jae Hyuk Lee, Dong Hyun Jang, D. Kim, Hyunglan Chang, Hyuksool Kwon, Seonghye Kim, Taek Soo Kim, You Hwan Jo

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Although there are well-established small-animal sepsis models, the longitudinal assessment of hemodynamic variables, laboratory values, and blood culture in a single living sepsis model is limited. Therefore, we aimed to comprehensively characterize fecal peritonitis–induced sepsis in a porcine model. Materials and methods: Autologous feces (1 g/kg) was administered into the peritoneum of 11 male pigs (49 ± 8 kg). The pigs were monitored up to 12 h with full fluid and vasopressor support to maintain the mean arterial pressure at >65 mm Hg. Longitudinal blood culture and laboratory values were obtained at defined time intervals. The cytokine levels in plasma were analyzed. Furthermore, a clinical registry of sepsis patients at a single emergency department was used to compare the Sepsis-related Organ Failure Assessment scores with those of the porcine model. Results: The hyperdynamic phase of increasing cardiac output with decreasing systemic vascular resistance was maintained until 2 h, followed by the reverse (hypodynamic phase). With the escalating requirement for fluid and vasopressor, the lactate level progressively increased while the platelet count, urine output, and serum albumin level consistently decreased. Bacteremia developed 7 h (median) after the administration of feces, and Escherichia coli was the most common pathogen. The pattern of Sepsis-related Organ Failure Assessment scores with prominent cardiovascular failure was comparable to clinical data. Conclusions: We implemented a porcine fecal peritonitis–induced sepsis model that demonstrates culture-proven bacteremia and multiple organ failure, particularly cardiovascular system failure. This model could facilitate the development of technologies for the early diagnosis of bacterial pathogens in blood.

Original languageEnglish
Pages (from-to)492-501
Number of pages10
JournalJournal of Surgical Research
Volume244
DOIs
StatePublished - 1 Dec 2019

Fingerprint

Sepsis
Swine
Organ Dysfunction Scores
Bacteremia
Feces
Multiple Organ Failure
Peritoneum
Cardiovascular System
Platelet Count
Serum Albumin
Cardiac Output
Vascular Resistance
Registries
Hospital Emergency Service
Early Diagnosis
Lactic Acid
Arterial Pressure
Animal Models
Hemodynamics
Urine

Keywords

  • Bacteremia
  • Fecal peritonitis
  • Pig
  • Sepsis

Cite this

Park, I. ; Lee, Jae Hyuk ; Jang, Dong Hyun ; Kim, D. ; Chang, Hyunglan ; Kwon, Hyuksool ; Kim, Seonghye ; Kim, Taek Soo ; Jo, You Hwan. / Characterization of Fecal Peritonitis–Induced Sepsis in a Porcine Model. In: Journal of Surgical Research. 2019 ; Vol. 244. pp. 492-501.
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abstract = "Background: Although there are well-established small-animal sepsis models, the longitudinal assessment of hemodynamic variables, laboratory values, and blood culture in a single living sepsis model is limited. Therefore, we aimed to comprehensively characterize fecal peritonitis–induced sepsis in a porcine model. Materials and methods: Autologous feces (1 g/kg) was administered into the peritoneum of 11 male pigs (49 ± 8 kg). The pigs were monitored up to 12 h with full fluid and vasopressor support to maintain the mean arterial pressure at >65 mm Hg. Longitudinal blood culture and laboratory values were obtained at defined time intervals. The cytokine levels in plasma were analyzed. Furthermore, a clinical registry of sepsis patients at a single emergency department was used to compare the Sepsis-related Organ Failure Assessment scores with those of the porcine model. Results: The hyperdynamic phase of increasing cardiac output with decreasing systemic vascular resistance was maintained until 2 h, followed by the reverse (hypodynamic phase). With the escalating requirement for fluid and vasopressor, the lactate level progressively increased while the platelet count, urine output, and serum albumin level consistently decreased. Bacteremia developed 7 h (median) after the administration of feces, and Escherichia coli was the most common pathogen. The pattern of Sepsis-related Organ Failure Assessment scores with prominent cardiovascular failure was comparable to clinical data. Conclusions: We implemented a porcine fecal peritonitis–induced sepsis model that demonstrates culture-proven bacteremia and multiple organ failure, particularly cardiovascular system failure. This model could facilitate the development of technologies for the early diagnosis of bacterial pathogens in blood.",
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Park, I, Lee, JH, Jang, DH, Kim, D, Chang, H, Kwon, H, Kim, S, Kim, TS & Jo, YH 2019, 'Characterization of Fecal Peritonitis–Induced Sepsis in a Porcine Model', Journal of Surgical Research, vol. 244, pp. 492-501. https://doi.org/10.1016/j.jss.2019.06.094

Characterization of Fecal Peritonitis–Induced Sepsis in a Porcine Model. / Park, I.; Lee, Jae Hyuk; Jang, Dong Hyun; Kim, D.; Chang, Hyunglan; Kwon, Hyuksool; Kim, Seonghye; Kim, Taek Soo; Jo, You Hwan.

In: Journal of Surgical Research, Vol. 244, 01.12.2019, p. 492-501.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Characterization of Fecal Peritonitis–Induced Sepsis in a Porcine Model

AU - Park, I.

AU - Lee, Jae Hyuk

AU - Jang, Dong Hyun

AU - Kim, D.

AU - Chang, Hyunglan

AU - Kwon, Hyuksool

AU - Kim, Seonghye

AU - Kim, Taek Soo

AU - Jo, You Hwan

PY - 2019/12/1

Y1 - 2019/12/1

N2 - Background: Although there are well-established small-animal sepsis models, the longitudinal assessment of hemodynamic variables, laboratory values, and blood culture in a single living sepsis model is limited. Therefore, we aimed to comprehensively characterize fecal peritonitis–induced sepsis in a porcine model. Materials and methods: Autologous feces (1 g/kg) was administered into the peritoneum of 11 male pigs (49 ± 8 kg). The pigs were monitored up to 12 h with full fluid and vasopressor support to maintain the mean arterial pressure at >65 mm Hg. Longitudinal blood culture and laboratory values were obtained at defined time intervals. The cytokine levels in plasma were analyzed. Furthermore, a clinical registry of sepsis patients at a single emergency department was used to compare the Sepsis-related Organ Failure Assessment scores with those of the porcine model. Results: The hyperdynamic phase of increasing cardiac output with decreasing systemic vascular resistance was maintained until 2 h, followed by the reverse (hypodynamic phase). With the escalating requirement for fluid and vasopressor, the lactate level progressively increased while the platelet count, urine output, and serum albumin level consistently decreased. Bacteremia developed 7 h (median) after the administration of feces, and Escherichia coli was the most common pathogen. The pattern of Sepsis-related Organ Failure Assessment scores with prominent cardiovascular failure was comparable to clinical data. Conclusions: We implemented a porcine fecal peritonitis–induced sepsis model that demonstrates culture-proven bacteremia and multiple organ failure, particularly cardiovascular system failure. This model could facilitate the development of technologies for the early diagnosis of bacterial pathogens in blood.

AB - Background: Although there are well-established small-animal sepsis models, the longitudinal assessment of hemodynamic variables, laboratory values, and blood culture in a single living sepsis model is limited. Therefore, we aimed to comprehensively characterize fecal peritonitis–induced sepsis in a porcine model. Materials and methods: Autologous feces (1 g/kg) was administered into the peritoneum of 11 male pigs (49 ± 8 kg). The pigs were monitored up to 12 h with full fluid and vasopressor support to maintain the mean arterial pressure at >65 mm Hg. Longitudinal blood culture and laboratory values were obtained at defined time intervals. The cytokine levels in plasma were analyzed. Furthermore, a clinical registry of sepsis patients at a single emergency department was used to compare the Sepsis-related Organ Failure Assessment scores with those of the porcine model. Results: The hyperdynamic phase of increasing cardiac output with decreasing systemic vascular resistance was maintained until 2 h, followed by the reverse (hypodynamic phase). With the escalating requirement for fluid and vasopressor, the lactate level progressively increased while the platelet count, urine output, and serum albumin level consistently decreased. Bacteremia developed 7 h (median) after the administration of feces, and Escherichia coli was the most common pathogen. The pattern of Sepsis-related Organ Failure Assessment scores with prominent cardiovascular failure was comparable to clinical data. Conclusions: We implemented a porcine fecal peritonitis–induced sepsis model that demonstrates culture-proven bacteremia and multiple organ failure, particularly cardiovascular system failure. This model could facilitate the development of technologies for the early diagnosis of bacterial pathogens in blood.

KW - Bacteremia

KW - Fecal peritonitis

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