Related Experiment Video
Updated: Aug 18, 2025
Design of Cecal Ligation and Puncture and Intranasal Infection Dual Model of Sepsis-Induced Immunosuppression
Published on: June 15, 2019
Disseminated Intravascular Coagulation (DIC): Old player creates new perspectives on the polymicrobial sepsis model
Julia van der Linde1, Stephan Diedrich1, Thorben Klee2
1Department of General, Visceral, Thoracic and Vascular Surgery, University Medical Center Greifswald, Greifswald, Germany.
Insights
The colon ascendens stent peritonitis (CASP) model effectively replicates human disseminated intravascular coagulation (DIC) in sepsis. This validated animal model aids research into DIC during abdominal sepsis.
Area of Science:
- Critical Care Medicine
- Hematology
- Sepsis Research
Background:
- Disseminated Intravascular Coagulation (DIC) is a severe sepsis complication, often fatal in surgical ICUs due to abdominal sepsis.
- Current animal models struggle to accurately represent the polymicrobial infections causing DIC.
- The International Society of Hemostasis and Thrombosis (ISTH) 2001 criteria define DIC using platelet count, bleeding time, D-dimer, and fibrinogen.
Purpose of the Study:
- To evaluate the colon ascendens stent peritonitis (CASP) model for its suitability in studying DIC.
- To determine if the CASP model can induce a coagulation disorder meeting ISTH criteria for DIC.
Main Methods:
- Mice underwent CASP surgery to induce polymicrobial sepsis.
- Coagulation parameters were assessed 20 hours post-operation.
- Methods included cell counts, bleeding times, rotational thromboelastometry (ROTEM), ELISAs for D-dimer and fibrinogen, and immunohistochemistry for platelet accumulation.
Main Results:
- The CASP model reliably induced thrombocytopenia and prolonged bleeding times.
- Significant fibrinogen loss in plasma and microvascular thrombosis in the liver were observed.
- The induced coagulation disorder met the ISTH 2001 criteria for DIC.
Conclusions:
- The CASP model is a comprehensive and reproducible animal model for studying DIC in murine abdominal sepsis.
- This model offers a more clinically relevant approach than artificial induction methods.
- CASP is a valuable tool for analyzing the complexities of DIC in polymicrobial sepsis.
Background:
Disseminated Intravascular Coagulation (DIC) is a life-threatening complication of sepsis. In surgical ICUs, DIC is frequently caused by abdominal sepsis, and the disarranged coagulation and complications often lead to death. The severity of sepsis is associated with a higher DIC score according to the parameters proposed by the International Society of Hemostasis and Thrombosis (ISTH) in 2001: platelet count, bleeding time (Quick), D-dimer, and fibrinogen. One problem in studying DIC is finding an adequate animal model that reflects the clinical situation of polymicrobial overwhelming infection.
Aims And Methods:
We investigated whether a well-established polymicrobial sepsis model of colon ascendens stent peritonitis (CASP) is suited to investigate the complexity of DIC. For this purpose, CASP-operated mice were examined 20 h after the operation with regard to coagulation parameters using cell counts, bleeding times, rotational thromboelastometry (ROTEM), ELISAs for D-dimer and fibrinogen, and platelet accumulation in affected organs via immunohistochemistry to see if the mice develop a coagulation disorder that meets the definition of DIC proposed by the ISTH 2001 consensus conference.
Results:
Herein, we showed that the CASP model is an all-encompassing animal model to analyze the complexity of systemic DIC in murine abdominal sepsis. There is highly reproducible thrombocytopenia, a significant prolongation of the bleeding time, and a loss of fibrinogen in plasma. We also observed microvascular thrombosis due to platelet accumulation in the microcirculation of the liver.
Conclusion:
The CASP model seems superior to other artificial models, e.g., injecting substances, for inducing DIC. CASP is one of the best true-to-life models for analyzing the complexity of disseminated intravascular coagulation in polymicrobial sepsis.
