0738. Mortality is associated with early tachycardia and cardiac troponin release in a fluid-resuscitated rat model of s
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POSTER PRESENTATION
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0738. Mortality is associated with early tachycardia and cardiac troponin release in a fluid-resuscitated rat model of sepsis W Khaliq*, M Singer From ESICM LIVES 2014 Barcelona, Spain. 27 September - 1 October 2014 Introduction Tachycardia and high troponin levels prognosticate for poor outcomes in human sepsis [1]. Reducing cardiac stress with beta-blockade has been proposed as an important therapeutic strategy as high catecholamine levels are injurious [2]. We have characterized a 72h fluid-resuscitated rat model of faecal peritonitis where prognostication can be made with high sensitivity and specificity at 6h from heart rate and stroke volume [3]. Objectives To determine whether non-survival is associated with early changes in troponin release and circulating catecholamine levels. Methods Male Wistar rats (325 ± 15g) underwent insertion of tunneled carotid arterial and jugular venous lines under isoflurane anaesthesia, followed by immediate i.p. injection of 4µl/g faecal slurry. Control animals were treated identically but without i.p. injection of slurry. Once awake, attachment to a swivel-tether system allowed
animals to move freely and access food and water ad libitum. Fluid resuscitation (50:50 mixture of 5% dextrose/Hartmann’s; 10ml/kg/h) was commenced at 2h. At 6h, echocardiography was used to measure heart rate and stroke volume. Animals were observed until 72h to assess survival. In a second experiment septic animals underwent echocardiography at 6h followed by sacrifice and blood and tissue sampling. We here report plasma catecholamine and troponin T levels (measured by ELISA) in predicted survivors and non-survivors, and sham-operated controls.
Results Septic animals (n = 16) had a mortality rate of 56%, with death occurring between 18-36h. A heart rate cut point of 460/min measured at 6h prognosticated 3-day survival with sensitivity of 0.88 and specificity of 0.92. Clinical features of illness at this timepoint were however mild. Table 1 shows significant differences in haemodynamics and troponin levels between predicted survivors and non-survivors. Catecholamine levels, while elevated over non-septic controls, were similar.
Table 1 Control (n=6)
Predicted survival (n=6)
Predicted non-survival (n=6)
Heart rate (bpm)
390 ± 21
442 ± 17
488 ± 18*
Stroke volume (mL)
0.40 ± 0.03
0.25 ± 0.02
0.18 ± 0.02*
Adrenaline (ng/mL)
8.56 ± 0.42
9.44 ± 0.23
10.3 ± 0.18
Noradrenaline (ng/mL)
1.60 ± 0.25
3.21 ± 0.23
2.98 ± 0.27
Troponin (pg/mL)
171 ± 24
168 ± 15
311 ± 47*
Data shown as median ± SE; * p
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