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How They Potentiate Tumor Necrosis Factor Release and Exacerbate Complications Associated With Sepsis

Louis F. Martin, MD; Thomas C. Vary, PhD; Paul K. Davis, MD; Bryce L. Munger, MD; James C. Lynch, MS; Sheila Spangler, MT, ASCP; Daniel G. Remick, MD

Arch Surg. 1991;126(9):1087-1093.

Abstract
• We tested the hypothesis that long-term intravascular cannulation exacerbates the harmful effects of an infectious challenge. Four groups of rats were initially studied: rats without intravascular catheters or infection (group 1), rats without catheters with a polymicrobial infection (group 2), rats with catheters but no infection (group 3), and rats with catheters and infection (group 4). Infected animals had an increased mortality and generated a significantly increased tumor necrosis factor response compared with noninfected animals. Animals with catheters and infection generated far less cardiac output than animals from the other three groups. No histologic changes differentiated the four groups. Therefore, the presence of a sterile intravascular catheter significantly increases cardiac dysfunction and mortality rates in rats with chronic bacteremia. These results suggest that intravascular plastic catheters potentiate the destructive cascade of events produced by the host in response to bacteremia.

(Arch Surg. 1991;126:1087-1093)

Author Affiliations
From the Departments of Surgery (Drs Martin and Davis and Ms Spangler), Cellular and Molecular Physiology (Drs Martin and Vary), Anatomy (Dr Munger), and Center for Biostatistics and Epidemiology (Mr Lynch), Penn State University College of Medicine, Hershey, Pa; and the Department of Pathology, University of Michigan Medical School, Ann Arbor (Dr Remick).

Footnotes
Accepted for publication January 12, 1991.

Presented at the Ninth Annual Meeting of the Surgical Infection Society, Denver, Colo, April 13, 1989.

Reprint requests to Department of Surgery, Penn State University College of Medicine, PO Box 850, Hershey, PA 17033 (Dr Martin).

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