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The gut as source of sepsis after hemorrhagic shock
1Department of Surgery, University of Medicine and Dentistry, New Jersey Medical School, Newark 07103.
Abstract:
In a model of severe hemorrhagic shock in rats, blood culture findings became positive within 2 to 4 hours of shock. The organisms cultured were primarily gram-negative. To test the hypothesis that the gut was the source of the bacteria, E. coli labeled with carbon-14 oleic acid were fed to rats undergoing hemorrhagic shock. Their plasma was then assayed for carbon-14 activity. Seven of the 14 shocked animals demonstrated increased plasma carbon-14 activity during or after shock. The mortality rate was 100 percent 80 hours postshock, and all animals had E. coli on subsequent blood culture. The seven rats without increased plasma carbon-14 activity had a survival rate of 83 percent postshock. Sham-shocked animals did not exhibit plasma carbon-14 levels greater than the background levels. These data suggest that bacterial translocation occurs during hemorrhagic shock and that the gut is the source of the bacteremia seen during hemorrhagic shock.
Insights
Bacterial translocation from the gut causes bacteremia during hemorrhagic shock. This study demonstrates that E. coli translocation during shock leads to higher mortality rates in rats.
Area of Science:
- Microbiology
- Physiology
- Surgical Research
Background:
- Severe hemorrhagic shock can lead to positive blood cultures, indicating bacterial presence.
- The gastrointestinal tract is a potential source of bacteria during systemic stress.
Purpose of the Study:
- To investigate the gut as the source of bacteremia in a rat model of hemorrhagic shock.
- To determine if bacterial translocation occurs during severe hemorrhagic shock.
Main Methods:
- Rats were fed E. coli labeled with carbon-14 oleic acid.
- Rats underwent induced hemorrhagic shock.
- Plasma carbon-14 activity was measured to detect bacterial translocation.
- Survival rates and blood cultures were analyzed post-shock.
Main Results:
- Seven of 14 shocked rats showed increased plasma carbon-14 activity, indicating bacterial translocation.
- Shocked rats with detectable translocation had a 100% mortality rate by 80 hours.
- Shocked rats without detectable translocation had an 83% survival rate.
- Sham-shocked animals did not show elevated plasma carbon-14 levels.
Conclusions:
- Bacterial translocation from the gut occurs during severe hemorrhagic shock in rats.
- The gut is the source of bacteremia observed during hemorrhagic shock.
- Bacterial translocation during shock is associated with increased mortality.