Peritonitis in the baboon: A primate model which simulates human sepsis

The physiological, hemostatic, and immunological responses of 12 chronicall y instrumented conscious baboons with sepsis due to Escherichia coli perito nitis were compared with that of similarly instrumented controls. Chronic i ndwelling cannulae were placed in the aorta and pulmonary artery to monitor pressure, cardiac output, and obtain blood samples. At t = 0 a sterile or E, coil-laden fibrin clot containing 1.9-6.7 x 10(11) CFU/kg was introduced into the peritoneal cavity. The control animals were group I (n = 3). The animals with peritonitis were divided into three groups depending on their clinical response. Group 2 animals (n = 3) were clinically well at the time of sacrifice (day 14), group 3 (n = 4) survived but were obviously sick on day 14, and group 4 (n = 5) died of sepsis. implantation of a sterile fibr in clot was well tolerated with little hemodynamic change and a transient m inimal inflammatory response In group 1. Implantation of an E. coli-contain ing clot elicited a hyperdynamic cardiovascular response and evoked a marke d inflammatory reaction and a disseminated intravascular coagulopathy. Five of 12 (42%) E. coli animals died from sepsis. In general, the physiologica l, hemostatic, and immunological disturbances tended to be greatest in thes e animals. Autopsy revealed residual peritoneal inflammation and varying de grees of inflammation in the lungs, adrenal, spleen, liver, and kidneys in all the animals that received E. coli with the inflammatory infiltrate incr easing in severity from group 2 through group 4. Tissue necrosis was observ ed only in the latter group. We conclude that the cardiovascular, hemostati c, and immunological responses of baboons with sepsis due to E. coli perito nitis exhibit a variable course that resembles the clinical manifestations of gram-negative sepsis in humans.