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Medicina Intensiva
versão impressa ISSN 0210-5691
Resumo
HERRERA-GUTIERREZ, M.E. et al. Development of a septic shock experimental model oriented at training: Application in the training of depuration techniques in the management of severe sepsis. Med. Intensiva [online]. 2011, vol.35, n.2, pp.84-91. ISSN 0210-5691.
Objective: To define a septic shock experimental model that can be used in for training in the early management of septic shock, specifically by extracorporeal depuration (ECD). Design: A case-control experimental study. Setting: Veterinary university hospital. Subjects: Ten Beagle dogs (weight 12-15kg). Interventions: Shock was induced using 1mg/kg Escherichia coli lipopolysaccharide (LPS) diluted in 20mL saline infused in 10minutes, with a subsequent follow-up at 6hours. There was no intervention in 5 animals in order to define the natural course of the shock and 5 underwent high volume hemofiltration (HVHF, 100mL/kg/h) to define delay in response to treatment. Variables: Pressures (arterial and pulmonary), hemodynamic parameters, gastric tonometry and respiratory function were recorded. Results: The LPS effect was evidenced at 2minutes of the infusion and the 10 animals showed severe shock at the end of the infusion. At 2-hours, changes between treated and non-treated animals were seen in cardiac output, systolic volume variability and mucous CO2. Mean arterial pressure was significantly different at four hours. All non-treated subjects died during the 6-hour follow-up and all the treated animals survived for this period. Based on these results, we developed a workshop that has been used in five courses (www.ccmijesususon.com - www.crrtcordoba.com.es/), obtaining the previous results. Conclusions: Our shock model shows a predictable behavior, very short latency and a sufficiently rapid improvement in the treated animals for it to be applied in training workshops. It is useful for training in the high-volume hemofilitration (HVHF) and can be used for training in the early management of septic shock.
Palavras-chave : Septic shock; Extracorporeal depuration; Animal research.