Document Detail

Impact of Endotoxin Challenge in Obese Pigs.
MedLine Citation:
PMID:  24569508     Owner:  NLM     Status:  Publisher    
Studies exploring the influence of obesity on septic shock remain limited and controversial. Pigs were chosen as a clinically relevant species, resembling to humans in various functions. We hypothese obesity may impair porcine acute endotoxic shock. Four groups of five "Yucatan" minipigs were studied: lean and obese control groups, lean LPS group receiving Escherichia Coli endotoxin (LPS) and obese LPS group receiving the same endotoxin dose. We measured hemodynamic and oxygenation parameters, skin microvascular blood flow at rest and during reactive hyperemia, von Willebrand factor, TNFα and Interleukin 6. All measurements were performed at baseline and at 30, 60, 90, 150 and 300 minutes. Results were given as median with 25-75 interquartile range. Control groups remained stable during the study-period. In LPS groups, administration of endotoxin resulted in a typical hypokinetic shock. In obese LPS group at 300 min, we observed a significant impairment of cardiac index (1.2 [1.06-1.45] vs. 1.7 [1.57-1.97] L/min/m, p=0.008) compared to lean LPS group; moreover pulmonary hypertension (mean arterial pressure: 42 [39-47] vs. 32 [28-34] mmHg, p=0.008), hypoxemia (partial pressure of oxygen: 216 [178-262] vs. 325 [285-414] mmHg, p=0.02) and lactate levels (5.8 [4.2-6.8] vs. 3.9 [2.2-5.5] mmol/L, p=0.04) were significantly higher compared to lean LPS group. Throughout the study, rest flow and peak flow during reactive hyperemia were more decreased in obese LPS group. Compared to lean LPS group, TNFα levels at 60 min (269 [178-428] vs. 126 [105-166] ng/mL, p=0.03) and interleukin 6 levels at 300 min (101 [61-142] vs. 52 [36-64] ng/mL, p=0.03) were significantly higher in obese LPS group. In our model of endotoxic shock, obese pigs developed a more severe hemodynamic failure with pronounced microcirculatory dysfunction and proinflammatory response.
Thibault Duburcq; Thomas Hubert; Pierre Saint-Léger; Jacques Mangalaboyi; Raphael Favory; Valery Gmyr; Laurence Quintane; Anne Tailleux; Bart Staels; Antoine Tournoys; François Pattou; Mercé Jourdain
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-2-24
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  -     ISSN:  1540-0514     ISO Abbreviation:  Shock     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-2-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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