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KMID : 1100620140010020120
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Clinical and Experimental Emergency Medicine
2014 Volume.1 No. 2 p.120 ~ p.125
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Rapid rewarming after therapeutic hypothermia worsens outcome in sepsis
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Jo You-Hwan
Kim Kyu-Seok
Lee Jae-Hyuk
Rim Kwang-Pil
Cho In-Soo
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Abstract
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Objective:This study was performed to investigate the effect of the rewarming rate on survival and acute lung injury in sepsis.
Methods:Male Sprague-Dawley rats underwent cecal ligation and incision. After 1 hour of sepsis induction, normothermia (37°C±0.5°C, NT group) or hypothermia (32°C±0.5°C) was induced. Hypothermia was maintained for 4 hours and rats were divided into two groups according to the rewarming rate: RW1 group, 1 hour of rewarming; and RW2 group, 2 hours of rewarming. In the survival study, rats were observed for 12 hours after sepsis induction (n=6 per group). In the second experiment, rats were sacrificed 7 hours after sepsis induction, and lung tissues and plasma were harvested (n=10 per group).
Results:In the survival study, the RW2 group survived longer than the RW1 group (P<0.05), but the RW1 and NT groups showed no significant difference in survival duration (P>0.05). The histological lung injury score and malondialdehyde concentrations in the lung tissues were significantly higher in the RW1 group than in the RW2 group (P<0.05). Plasma interleukin (IL)-6 concentration and the ratio of IL-6 to IL-10 were higher in the RW1 group than in the RW2 group (P<0.05).
Conclusion:Rapid rewarming after therapeutic hypothermia results in a shorter survival period and acute lung injury in sepsis, which could be associated with the inflammatory responses.
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KEYWORD
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Hypothermia, Rewarming, Sepsis, Survival, Lung injury
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