Heart rate elevations during early sepsis predict death in fluid-resuscitated rats with fecal peritonitis

被引：12

作者：

Rudiger A. ^{[1
]}

Jeger V. ^{[1
,2
]}

Arrigo M. ^{[3
]}

Schaer C.A. ^{[1
,2
]}

Hildenbrand F.F. ^{[2
]}

Arras M. ^{[4
]}

Seifert B. ^{[5
]}

Singer M. ^{[6
]}

Schoedon G. ^{[2
]}

Spahn D.R. ^{[1
]}

Bettex D. ^{[1
]}

机构：

[1] Institute of Anesthesiology, University and University Hospital Zurich, Raemistrasse 100, Zurich

[2] Inflammation Research Unit, Division of Internal Medicine, University and University Hospital Zurich, Raemistrasse 100, Zurich

[3] Clinic for Cardiology, University Heart Centre, University and University Hospital Zurich, Raemistrasse 100, Zurich

[4] Department of Surgery, University and University Hospital Zurich, Raemistrasse 100, Zurich

[5] Department of Biostatistics at Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, Zurich

[6] Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, Gower Street, London

来源：

Intensive Care Medicine Experimental | / 6卷 / 1期

关键词：

Animal model; Electrocardiogram; Fecal peritonitis; Heart rate; Outcome; Sepsis; Telemetry;

D O I：

10.1186/s40635-018-0190-5

中图分类号：

学科分类号：

摘要：

Background: In sepsis, early outcome prediction would allow investigation of both adaptive mechanisms underlying survival and maladaptive mechanisms resulting in death. The aim of this study was to test whether early changes in heart rate monitored by telemetry could predict outcome in a long-term rat model of fecal peritonitis. Methods: Male Wistar rats (n = 24) were instrumented with a central venous line for administration of fluids, antibiotics and analgesics. A telemetry transmitter continuously collected electrocardiogram signals. Sepsis was induced by intraperitoneal injection of fecal slurry, and the animals were observed for 48 h. Additional animals underwent arterial cannulation at baseline (n = 9), 4 h (n = 16), or 24 h (n = 6) for physiology and laboratory measurements. Results: 48-h mortality was 33% (8/24), with all deaths occurring between 4 and 22 h. Septic animals were characterized by lethargy, fever, tachycardia, positive blood cultures, and elevated cytokine (IL-1, IL-6, TNF alpha) levels. An increase in heart rate ≥ 50 bpm during the first 4 h of sepsis predicted death with sensitivity and specificity of 88% (p = 0.001). Conclusions: In this long-term rat sepsis model, prognostication could be made early by telemetry-monitored changes in heart rate. This model enables the study of underlying mechanisms and the assessment of any differential effects of novel therapies in predicted survivors or non-survivors. © 2018, The Author(s).

引用

共 40 条

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