Effects of mild hypothermia on the heart of swine with septic shock / 中华急诊医学杂志

ABSTRACT

Objective To investigate the protective effects of mild hypothenmia on myocardium of porcine with septic shock. Method A total of 24 Guishou miniature pigs were randomly(random number) divided into the pre-shock mild hypothermia group, shock mild hypothermia group and shock normothermia control group with 8 in each group. After the anesthesia of pigs, E. coli endotoxin was injected into femoral vein to establish the sepsis model of swine. After modeling, normal saline was continuously administered into femoral vein of pigs in three groups with in-fusion pump at steady speed. In the pre-shock mild hypothermia group,4 ℃ normal saline was used for intravenous injection to produce mild hypothermia before E. eoli endotoxin injection. In the shock mild hypothermia group, 38 ℃ saline was used at first and the 4 ℃ saline was employed after the systolic pressure of mice dropped to 60% of the o-riginal pressure for one hour. In shock normothermia group,38 ℃ saline was used from the beginning to the end of the experiment. The hemodynamics, blood lactate, CtnI, coronary angiography for detecting TIMI flow and the ultra-structural changes under electron microscopy were observed 6 h and 12 h after temperature intervention. Results (1) In pre-shock mild hypothermia group, the findings in all of observation were better than those in shock mild hy-pothermia group and shock normothennia group 6 h and 12 h after temperature intervention (P < 0.01). (2) In shock mild hypothermia group, the CtnI was lower and the ultra-structural changes were less severe than those in shock normothermia group (P < 0.05), but there were no significant differences in blood lactate, TIMI and hemody-namies between shock mild hypotherrnia group and shock normothermia group (P > 0.05). (3) There were no sig-nificant differences in all measurements between shock mild hypothermia group and shock normothennia group after 12 hours later (P > 0.05). Conclusions Mild hypothermia has some protective effects on myocardium of swine with sepsis. If the mild hypothermia is employed before the emergence of shock, the protective effects would be more ef-fective and the cardiac function would maintain at higher efficiency. If the hypothermia is used after the occmTence of shock, it could blunt the cardiac damage and preserve the cardiac function in some extent.