Pre-existing systemic inflammation attenuates bacterial clearance by the liver in porcine abdominal sepsis

Abstract

Issue Title: ESICM LIVES 2015

Hanslin et al. Intensive Care Medicine Experimental 2015, 3(Suppl 1):A620 http://www.icm-experimental.com/content/3/S1/A620

POSTER PRESENTATION Open Access

Pre-existing systemic inflammation attenuates bacterial clearance by the liver in porcine abdominal sepsis

K Hanslin1*, J Sjlin1, P Skorup1, F Wilske1, R Frithiof2, A Larsson3, M Castegren1, M Lipcsey2

From ESICM LIVES 2015Berlin, Germany. 3-7 October 2015

Introduction

Bacterial translocation from the gut has been suggested to induce and maintain the systemic inflammatory response (SIRS) and organ dysfunction. The reticuloendothelial system in the liver has a pivotal role in clearing the blood from circulating bacteria. To date, the effects of SIRS on hepatic bacterial clearance are not fully understood.

Objectives

To investigate if pre-existing inflammation, as seen in sepsis, influences the trans-hepatic bacterial clearance.

Methods

The study was conducted on anesthetized pigs in an intensive care setting. All animals were subjected to an infusion of E coli in the portal vein for 3 hours. In Group 1 (n=6), a systemic inflammatory response was induced by a continuous intravenous endotoxin infusion starting 24 h prior to the bacterial infusion. Group 2 (n=6) received the bacterial infusion without prior endotoxin exposure. Three animals (Group 3), serving as controls for effects of 24 h anesthesia, received saline instead of endotoxin for 24 h prior to the bacterial infusion. Bacterial counts in the portal and hepatic vein, as well as the levels of tumor necrosis factor-a (TNF-a) in venous blood were analyzed hourly during the bacterial infusion.

Results

All animals subjected to endotoxin developed SIRS. The amounts of bacteria administered were comparable

between the groups. The ratio of hepatic to portal vein bacterial counts was higher in Group 1 vs. 2 (p < 0.001; Figure 1). Peak plasma levels of TNF-a in Group 1 (1957 pg/mL (1843-2092) median (IQR)) were lower compared to Group 2 (69200 pg/mL (60305-77350); p <0.001). Group 3 was numerically intermediate in bacterial counts and TNF-a levels and, according to the predefined plan, not included in the primary analysis.

Conclusions

Our results suggest that despite lower inflammatory response to bacterial infusion, the trans-hepatic bacterial clearance is a magnitude lower in pigs with pre-existing systemic inflammatory response. Should similar mechanisms operate in human critical illness, then hepatic clearance of bacteria from the gut is impaired by SIRS.

1Uppsala University, Section of Infectious Diseases, Department of Medical Sciences, Uppsala, SwedenFull list of author information is available at the end of the article

Figure 1

2015 Hanslin et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0

Web End =http:// http://creativecommons.org/licenses/by/4.0

Web End =creativecommons.org/licenses/by/4.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Hanslin et al. Intensive Care Medicine Experimental 2015, 3(Suppl 1):A620 http://www.icm-experimental.com/content/3/S1/A620

Page 2 of 2

Authors details

1Uppsala University, Section of Infectious Diseases, Department of Medical Sciences, Uppsala, Sweden. 2Uppsala University, Section of Anesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala, Sweden.

3Uppsala University, Section of Clinical Chemistry, Department of Medical Sciences, Uppsala, Sweden.

Published: 1 October 2015

doi:10.1186/2197-425X-3-S1-A620Cite this article as: Hanslin et al.: Pre-existing systemic inflammation attenuates bacterial clearance by the liver in porcine abdominal sepsis. Intensive Care Medicine Experimental 2015 3(Suppl 1):A620.

Submit your manuscript to a journal and benet from:

7 Convenient online submission7 Rigorous peer review7 Immediate publication on acceptance7 Open access: articles freely available onlihttp://www.springeropen.com/

Web End =ne 7 High visibility within the eld7 Retaining the copyright to your article

Submit your next manuscript at 7 http://www.springeropen.com/

Web End =springeropen.com