Long Term Objective: To elucidate the link between hemorrhagic and septic shock and to determine better methods of prevention and treatment. We have developed a model of treated, maintained, hemorrhagic shock in the rat in which post shock treatment purely by manipulating the maintenance infusion results in 24 hour survival in most of the experimental animals despite shock levels of a severity never before employed. All of these animals eventually die but this occurs on the second or third day after shock. We claim that the pattern of mortality in the treated maintained shock model much more closely mimics the clinical situation. We have recently found that there is a bacterial invasion of portal and systemic blood in most of these rats by 24 hours after shock. Using this model we propose to address the following specific aims: (1) What are the characteristics of bacterial invasion in the rat during and after treated shock? When does it begin and what is the type and number of bacteria involved? (2) Is the bacterial invasion directly related to the death of the animals? (3) Does initiation of the complement cascade and other phenomena of the immune system precede, follow or coincide with bacterial invasions? (4) Is the source of bacterial invasion the gastrointestinal tract? (5) Can the bacterial invasion be treated by antibiotics and will this improve the long term survival of the animals? In pursuing these aims we will:
Aim 1) Extend our pilot observations of bacterial invasion in this model to include colony counts in tissue as well as increasing the number of animals observed.
Aim 2) We will observe survival when this model is used in germfree compared to conventional animals.
Aim 3) We will determine the time and amount of anaphylatoxins appearing in the model both in conventional and germfree animals.
Aim 4) We will use various techniques to label internal bacteria in rats used in this model and observe if labeled bacteria appear in the blood or organs.
Aim 5) We will determine the effect of the most potent currently available antibiotic combinations on survival in this model.

Agency
National Institute of Health (NIH)
Institute
National Institute of General Medical Sciences (NIGMS)
Type
Research Project (R01)
Project #
5R01GM037060-03
Application #
3292002
Study Section
Surgery, Anesthesiology and Trauma Study Section (SAT)
Project Start
1987-04-01
Project End
1990-03-31
Budget Start
1989-04-01
Budget End
1990-03-31
Support Year
3
Fiscal Year
1989
Total Cost
Indirect Cost
Name
University of Medicine & Dentistry of NJ
Department
Type
Schools of Medicine
DUNS #
605799469
City
Newark
State
NJ
Country
United States
Zip Code
07107
Schmidt, H; Rush, B; Simonian, G et al. (1996) Thalidomide inhibits TNF response and increases survival following endotoxin injection in rats. J Surg Res 63:143-6
Ferraro, F J; Rush Jr, B F; Simonian, G T et al. (1995) A comparison of survival at different degrees of hemorrhagic shock in germ-free and germ-bearing rats. Shock 4:117-20
Livingston, D H; Wang, M T; Hsieh, J et al. (1992) Hemorrhagic shock inhibits lipopolysaccharide-induced myelopoiesis in both germ-free and conventional rats. Surgery 112:773-9;discussion 779-80
Rush Jr, B F (1992) The bacterial factor in hemorrhagic shock. Surg Gynecol Obstet 175:285-92
Redan, J A; Rush, B F; McCullough, J N et al. (1990) Organ distribution of radiolabeled enteric Escherichia coli during and after hemorrhagic shock. Ann Surg 211:663-6;discussion 666-8
Redan, J A; Rush Jr, B F; Lysz, T W et al. (1990) Organ distribution of gut-derived bacteria caused by bowel manipulation or ischemia. Am J Surg 159:85-9;discussion 89-90
Rush Jr, B F; Redan, J A; Flanagan Jr, J J et al. (1989) Does the bacteremia observed in hemorrhagic shock have clinical significance? A study in germ-free animals. Ann Surg 210:342-5;discussion 346-7
Rush Jr, B F (1989) Irreversibility in hemorrhagic shock is caused by sepsis. Am Surg 55:204-8
Rush Jr, B F; Sori, A J; Murphy, T F et al. (1988) Endotoxemia and bacteremia during hemorrhagic shock. The link between trauma and sepsis? Ann Surg 207:549-54
Sori, A J; Rush Jr, B F; Lysz, T W et al. (1988) The gut as source of sepsis after hemorrhagic shock. Am J Surg 155:187-92