Vagus Nerve Stimulation Attenuates Multiple Organ Dysfunction in Resuscitated Porcine Progressive Sepsis
Language English Country United States Media print
Document type Journal Article
- MeSH
- Electric Stimulation Therapy MeSH
- Hemodynamics MeSH
- Hyperlactatemia blood prevention & control MeSH
- Disease Models, Animal MeSH
- Monocytes * MeSH
- Multiple Organ Failure physiopathology therapy MeSH
- Myocardium pathology MeSH
- Random Allocation MeSH
- Vagus Nerve * MeSH
- Leukocyte Count MeSH
- Swine MeSH
- Disease Progression MeSH
- Prospective Studies MeSH
- Sepsis physiopathology therapy MeSH
- Heart physiopathology MeSH
- Mitochondria, Heart physiology MeSH
- Vasoconstrictor Agents therapeutic use MeSH
- Organ Dysfunction Scores MeSH
- Animals MeSH
- Check Tag
- Male MeSH
- Female MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Vasoconstrictor Agents MeSH
OBJECTIVES: To investigate the potential benefits of vagus nerve stimulation in a clinically-relevant large animal model of progressive sepsis. DESIGN: Prospective, controlled, randomized trial. SETTING: University animal research laboratory. SUBJECTS: Twenty-five domestic pigs were divided into three groups: 1) sepsis group (eight pigs), 2) sepsis + vagus nerve stimulation group (nine pigs), and 3) control sham group (eight pigs). INTERVENTIONS: Sepsis was induced by cultivated autologous feces inoculation in anesthetized, mechanically ventilated, and surgically instrumented pigs and followed for 24 hours. Electrical stimulation of the cervical vagus nerve was initiated 6 hours after the induction of peritonitis and maintained throughout the experiment. MEASUREMENTS AND MAIN RESULTS: Measurements of hemodynamics, electrocardiography, biochemistry, blood gases, cytokines, and blood cells were collected at baseline (just before peritonitis induction) and at the end of the in vivo experiment (24 hr after peritonitis induction). Subsequent in vitro analyses addressed cardiac contractility and calcium handling in isolated tissues and myocytes and analyzed mitochondrial function by ultrasensitive oxygraphy. Vagus nerve stimulation partially or completely prevented the development of hyperlactatemia, hyperdynamic circulation, cellular myocardial depression, shift in sympathovagal balance toward sympathetic dominance, and cardiac mitochondrial dysfunction, and reduced the number of activated monocytes. Sequential Organ Failure Assessment scores and vasopressor requirements significantly decreased after vagus nerve stimulation. CONCLUSIONS: In a clinically-relevant large animal model of progressive sepsis, vagus nerve stimulation was associated with a number of beneficial effects that resulted in significantly attenuated multiple organ dysfunction and reduced vasopressor and fluid resuscitation requirements. This suggests that vagus nerve stimulation might provide a significant therapeutic potential that warrants further thorough investigation.
Biomedical Center Faculty of Medicine in Pilsen Charles University Pilsen Czech Republic
Department of Physiology Faculty of Medicine in Pilsen Charles University Pilsen Czech Republic
References provided by Crossref.org
Renal mitochondria response to sepsis: a sequential biopsy evaluation of experimental porcine model
Gut microbiome diversity of porcine peritonitis model of sepsis
The association between premorbid beta blocker exposure and mortality in sepsis-a systematic review
