Porcine model of peritonitis-induced sepsis is a well-established clinically relevant model of human disease. Interindividual variability of the response often complicates the interpretation of findings. To better understand the biological basis of the disease variability, the progression of the disease was compared between animals with sepsis and septic shock. Peritonitis was induced by inoculation of autologous feces in fifteen anesthetized, mechanically ventilated and surgically instrumented pigs and continued for 24 h. Cardiovascular and biochemical parameters were collected at baseline (just before peritonitis induction), 12 h, 18 h and 24 h (end of the experiment) after induction of peritonitis. Analysis of multiple parameters revealed the earliest significant differences between sepsis and septic shock groups in the sequential organ failure assessment (SOFA) score, systemic vascular resistance, partial pressure of oxygen in mixed venous blood and body temperature. Other significant functional differences developed later in the course of the disease. The data indicate that SOFA score, hemodynamical parameters and body temperature discriminate early between sepsis and septic shock in a clinically relevant porcine model. Early pronounced alterations of these parameters may herald a progression of the disease toward irreversible septic shock.

Biomedical Center Faculty of Medicine in Pilsen Charles University Alej Svobody 76 323 00 Pilsen Czech Republic

Department of Aneshesiology and Intensive Care Medicine Faculty of Medicine in Pilsen Charles University Alej Svobody 80 304 60 Pilsen Czech Republic

Department of Internal Medicine 1 Faculty of Medicine in Pilsen Charles University Alej Svobody 80 304 60 Pilsen Czech Republic

Department of Physiology Faculty of Medicine in Pilsen Charles University Alej Svobody 1655 76 323 00 Pilsen Czech Republic

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Sepsis as a Challenge for Personalized Medicine

Modeling sepsis, with a special focus on large animal models of porcine peritonitis and bacteremia