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2015 ; 3
(1
): 48
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Why do they die? Comparison of selected aspects of organ injury and dysfunction
in mice surviving and dying in acute abdominal sepsis
#MMPMID26215812
Drechsler S
; Weixelbaumer KM
; Weidinger A
; Raeven P
; Khadem A
; Redl H
; van Griensven M
; Bahrami S
; Remick D
; Kozlov A
; Osuchowski MF
Intensive Care Med Exp
2015[Dec]; 3
(1
): 48
PMID26215812
show ga
BACKGROUND: The mechanisms of sepsis mortality remain undefined. While there is
some evidence of organ damage, it is not clear whether this damage alone is
sufficient to cause death. Therefore, we aimed to examine contribution of organ
injury/dysfunction to early deaths in the mouse abdominal sepsis. METHODS: Female
OF-1 mice underwent either medium-severity cecal ligation and puncture (CLP-Only)
or non-lethal CLP-ODam (CLP with cisplatin/carbontetrachloride to induce
survivable hepatotoxicity and nephrotoxicity). In the first experiment, blood was
collected daily from survivors (SUR; CLP-Only and CLP-ODam groups) or until early
death (DIED; CLP-Only). In the second experiment (CLP-Only), early outcome was
prospectively predicted based on body temperature (BT) and pairs of mice
predicted to survive (P-SUR) and die (P-DIE) were sacrificed post-CLP. The
overall magnitude of organ injury/dysfunction was compared in retrospectively and
prospectively stratified mice. RESULTS: At day 7 post-CLP, survival in CLP-Only
was 48%, while CLP-ODam was non-lethal. In CLP-Only mice within 24 h of death,
urea increased to 78 (versus 40 mg/dl in SUR), ALT to 166 (vs. 108 U/l), LDH to
739 (vs. 438 U/l) and glucose declined to 43 (vs. 62 mg/dl). In CLP-ODam,
hypoglycemia was exacerbated (by 1.5-fold) and ALT and LDH were 20- and 8-fold
higher versus DIED (CLP-Only) mice. In CLP-Only, predicted deaths (P-DIE) were
preceded by a significant rise only in cystatin C (268 vs. 170 ng/ml in P-SUR)
but not in creatinine and troponin I. Respiratory function of mitochondria in the
liver and kidney of P-SUR and P-DIE CLP-Only mice was not impaired (vs. controls)
and ATP level in organs remained similar among all groups. Histologic injury
scores in the liver, kidney, heart and lung showed no major disparities among
dying, surviving and control mice. CONCLUSIONS: In CLP-Only mice, although the
deregulation of parameters indicative of organ injury/dysfunction was greater in
dying versus surviving mice, it never exceeded the changes in surviving CLP-ODam
animals, and it was not followed by histopathological damage and/or mitochondrial
dysfunction. This shows that interpretation of the contribution of the organ
injury/dysfunction to early deaths in the CLP model is not straightforward and
depends on the pathophysiological origin of the profiled disturbances.