SEPTIC SHOCK AND MULTIPLE ORGAN FAILURE D URING SURGICAL INTENSIVE-CARE - EVALUATION OF PULMONARY AND INTESTINAL DYSFUNCTION ASSESSMENT IN A PORCINE MODEL

The study deals with an animal model for the problems of surgical inte nsive care patients. Following repeated applications of E. coli endoto xin WO 111 : B4 under standard conditions, specific hemodynamic and bi ochemical (TNF, TXA2, PGI2, IL-6, PAF) and morphological (endothelium of the lung) alterations were detected. ARDS patterns induced by the s epsis were analyzed by high-frequency measurement of pressure and flow (385 measurements per breathing cycle). The role of the intestine in sepsis was investigated by ion-selective monitoring of surface potassi um activity comparing mucosa and serosa. Every injection of endotoxin was followed by a selective increase of the potassium activity reveali ng relative ischemia induced by the endotoxin. The profile of the pota ssium levels on the surface correlates both with the cardiac output an d with the prostacyclin levels. The continuous narrowing of the differ ence between mucosa and serosa, potassium during the period of investi gation can be regarded as evidence for pathologic change in permeabili ty fostering the septic course.