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Related Experiment Videos

Hemodynamic changes and gut barrier function in sequential hemorrhagic and endotoxic shock

R G Turnbull1, J A Talbot, S M Hamilton

  • 1Department of Surgery, University of Alberta, Edmonton, Canada.

The Journal of Trauma
|May 1, 1995
PubMed
Summary

The "two-hit" theory suggests a second stress exacerbates trauma, leading to multisystem organ failure (MSOF). This study in pigs found that endotoxin infusion after hemorrhagic shock worsened outcomes, supporting the two-hit hypothesis in trauma research.

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Area of Science:

  • Trauma and Surgical Critical Care
  • Immunology and Inflammation
  • Gastroenterology

Background:

  • Multisystem organ failure (MSOF) is a primary cause of mortality after trauma.
  • The gut is implicated as a source of systemic inflammation driving MSOF.
  • The "two-hit" theory posits that a second physiological stressor can precipitate MSOF after an initial insult.

Purpose of the Study:

  • To investigate the "two-hit" theory of MSOF.
  • To examine the hemodynamic and bacteriologic responses to a secondary stressor in a porcine model.
  • To compare outcomes following endotoxin or hemorrhagic shock followed by endotoxin.

Main Methods:

  • A subacute porcine model (n=18) was utilized.
  • Animals underwent instrumentation including vascular catheters and flow probes.

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  • Groups received either endotoxin, hemorrhagic shock then endotoxin, or hemorrhagic shock alone.

    • Main Results:

    • One animal in the hemorrhagic shock then endotoxin group died during endotoxic shock.
    • Hemodynamic and bacteriologic data were collected throughout the study.
    • Systemic blood and organs were cultured for bacterial analysis.

    Conclusions:

    • The study aimed to validate the "two-hit" theory in a trauma model.
    • Findings contribute to understanding the pathophysiology of MSOF.
    • Further research is needed to fully elucidate the mechanisms involved.