Abstract
BackgroundThe aim of the present work was to assess cerebral hemodynamic changes in a porcine model of E.coli induced fulminant sepsis.MethodsNineteen healthy female Hungahib pigs, 10–12 weeks old, randomly assigned into two groups: Control (n = 9) or Septic Group (n = 10). In the Sepsis group Escherichia coli culture suspended in physiological saline was intravenously administrated in a continuously increasing manner according to the following protocol: 2 ml of bacterial culture suspended in physiological saline was injected in the first 30 min, then 4 ml of bacterial culture was administered within 30 min, followed by infusion of 32 ml bacterial culture for 2 h. Control animals received identical amount of saline infusion. Systemic hemodynamic parameters were assessed by PiCCo monitoring, and cerebral hemodynamics by transcranial Doppler sonography (transorbital approach) in both groups.ResultsIn control animals, systemic hemodynamic variables and cerebral blood flow velocities and pulsatility indices were relatively stable during the entire procedure. In septic animals shock developed in 165 (IQR: 60–255) minutes after starting the injection of E.coli solution. Blood pressure values gradully decreased, whereas pulse rate increased. A decrease in cardiac index, an increased systemic vascular resistance, and an increased stroke volume variation were observed. Mean cerebral blood flow velocity in the middle cerebral artery did not change during the procedure, but pulsatility index significantly increased.ConclusionsThere is vasoconstriction at the level of the cerebral arterioles in the early phase of experimental sepsis that overwhelmes autoregulatory response. These results may serve as additional pathophysiological information on the cerebral hemodynamic changes occurring during the septic process and may contribute to a better understanding of the pathomechanism of septic encephalopathy.
Highlights
The aim of the present work was to assess cerebral hemodynamic changes in a porcine model of E.coli induced fulminant sepsis
In the Sepsis group Escherichia coli culture (2.5 × 105/ml; strain: ATCC 25922, Department of Medical Microbiology, University of Debrecen) suspended in physiological saline (Api NaCl 0.85 Medium and suspension medium, bioMérieux SA, Lyon, France) was intravenously administrated in a continuously increasing manner according to the following protocol: 2 ml of bacterial culture suspended in physiological saline was injected in the first 30 min, 4 ml of bacterial culture was administered within 30 min, followed by infusion of 32 ml bacterial culture for 2 h
Most probably due to seasonal variation of the animal experiments, three animals originally randomized to control group were excluded from the analysis, because the intial PiCCo measurements showed unusually increased baseline systemic vascular resistance index (SVRI) values
Summary
The aim of the present work was to assess cerebral hemodynamic changes in a porcine model of E.coli induced fulminant sepsis. Cerebral blood flow (CBF) has been reported to be unchanged [5, 6], decreased [7], or even increased [8, 9], depending on the experimental model, the species of the study animals and the progression and severity of sepsis. Molnár et al BMC Anesthesiology (2017) 17:98 studies have found decreased CBF in patients with sepsis, which suggests a possible causative role of cerebral ischemia in the development of neurological symptoms [10, 11]. Previous studies have reported on normal cerebral autoregulation and vasoreactivity in septic patients [13]. The majority of the previous observations were performed in humans or in animals with hyperdynamic sepsis and no information could be found on the cerebral blood flow and cerebral vasoreactivity in hypodynamic sepsis models
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