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Volume 2 Supplement 1

ESICM LIVES 2014

0082. Early circulating lipid and cytokine profiles prognosticate in a rat model of faecal peritonitis

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Introduction

In stress states, catecholamines induce lipolysis and insulin resistance with hyperglycaemia. Lipid profiles differ between surviving and non-surviving septic patients [1, 2] but, hitherto, little attention has been paid to this finding and its significance remains unknown. We used a previously characterized 72h fluid-resuscitated rat model of faecal peritonitis where prognostication can be made with high sensitivity and specificity as early as 6h from heart rate or stroke volume [3].

Objectives

To determine the relationship between early changes in plasma cytokine and metabolic profiles, and their prognostic significance.

Methods

Under general anaesthesia male Wistar rats (325±15g) underwent tunneled insertion of carotid arterial and jugular venous lines, followed by i.p. injection of 4µl/g faecal slurry. They were then woken and attached to a swivel-tether system allowing free movement in their cage with, from 2h, fluid resuscitation (1:1 mix of 5% dextrose:Hartmann's) at 10ml/kg/h. An echocardiography-measured HR cut-off of 460 bpm was used to classify animals into predicted survivors or non-survivors. At 6h, animals were sacrificed for blood and tissue sampling. We here report plasma levels of IL-6, IL-10, and a metabolic profile using blood gas analysis, ELISA and enzymatic colorometric testing.

Results

At 6h the animals manifested only mild clinical features of illness, however significant differences were seen in IL-6 and all lipid measurements between predicted survivors and non-survivors. Glucose, lactate and IL-10 levels did not differ. Table 1

Table 1 Table 1

Conclusions

In this long-term rat model of faecal peritonitis, predicted non-survivors had a significantly different IL-6 and lipid profile as early as 6 hours after sepsis. IL-6 impacts on lipid metabolism [4] but the relationship in sepsis has not, to our knowledge, been previously described. The impact of early hypolipidaemia on outcome warrants further investigation.

References

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    Barlage S, et al.: Changes in HDL-associated apolipoproteins relate to mortality in human sepsis and correlate to monocyte and platelet activation. Intensive Care Med 2009, 35: 1877–1885. 10.1007/s00134-009-1609-y

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    Cappi SB, et al.: Dyslipidemia: a prospective controlled randomized trial of intensive glycemic control in sepsis. Intensive Care Med 2012, 38: 634–641. 10.1007/s00134-011-2458-z

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    Rudiger A, et al.: Early functional and transcriptomic changes in the myocardium predict outcome in a long-term rat model of sepsis. Clin Sci 2013, 124: 391–401. 10.1042/CS20120334

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    Glund S, Krook A: . Acta Physiol (Oxf). 2008,192(1):37–48. 10.1111/j.1748-1716.2007.01779.x

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Grant acknowledgment

UK Intensive Care Foundation and NIHR

Author information

Correspondence to W Khaliq.

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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Keywords

  • Lipid
  • Catecholamine
  • Lipid Profile
  • Stroke Volume
  • Metabolic Profile