Fig 1.
After preparation and stabilization we induced peritonitis by instillation of autologous feces and the animals were randomized to intervention or control group in a blind manner. Untreated peritonitis preceded the onset of circulatory instability, when a protocolized resuscitation was initiated and intervention (or saline alone) was given at time points 0-, 4- and 8-hours. Piperacillin/Tazobactam 2 grams in 10 ml of 0.9% saline was given every 8 hours i.v. The total observation period for each animal after onset of circulatory instability was twenty hours or until death.
Fig 2.
Kaplan-Meyer analysis of survival.
Of a total of 8 + 8 animals, 9 survived the experiment until euthanasia (20 hours), while three and four animals died of refractory shock during the 20-hours observation period in treatment and control groups, respectively.
Table 1.
Measurements at baseline.
Table 2.
Respiratory parameters.
Table 3.
Hemodynamic parameters, blood gas analyses.
Table 4.
Fluid balance.
Table 5.
Wet-to-dry ratio.
Table 6.
TNF-alpha concentration.
Table 7.
IL-6 concentration in plasma.
Fig 3.
Histology of lung samples, AF-16 vs control.
3A Intense inflammatory cell reaction shows leukocytes rich in polymorphs in the alveoli (down, at left) and in the capillaries in the interlobular septum (AF-16). 3B Bronchial vessel shows leukocytes adhering at the endothelium. It could be an early stage in the process of leukocyte migration through the vessel wall, but leukocytes seem to remain in the intima which is suggestive of endoarteriolitis, which could be predisposing for thrombosis (control).
Table 8.
Lung histology.
Fig 4.
Histology of intestine and mesenterium.
4A The mucosa is down at left and the serosa is at right. The serosa shows a rich fibrinopurulent exudate, consistent with peritonitis. Leukocytes between the smooth muscle layers also are visible (AF-16). 4B Mesenterium. Necrosis and intense inflammatory reaction in the fat and connective tissues, consistent with peritonitis (control).