[Development of a septic shock experimental model oriented at training. Application in the training of depuration techniques in the management of severe sepsis].

OBJECTIVE To define a septic shock experimental model that can be used in for training in the early management of septic shock, specifically by extracorporeal depuration (ECD). DESIGN A case-control experimental study. SETTING Veterinary university hospital. SUBJECTS Ten Beagle dogs (weight 12-15kg). INTERVENTIONS Shock was induced using 1mg/kg Escherichia coli lipopolysaccharide (LPS) diluted in 20 mL saline infused in 10 minutes, with a subsequent follow-up at 6 hours. There was no intervention in 5 animals in order to define the natural course of the shock and 5 underwent high volume hemofiltration (HVHF, 100mL/kg/h) to define delay in response to treatment. VARIABLES Pressures (arterial and pulmonary), hemodynamic parameters, gastric tonometry and respiratory function were recorded. RESULTS The LPS effect was evidenced at 2 minutes of the infusion and the 10 animals showed severe shock at the end of the infusion. At 2-hours, changes between treated and non-treated animals were seen in cardiac output, systolic volume variability and mucous CO(2). Mean arterial pressure was significantly different at four hours. All non-treated subjects died during the 6-hour follow-up and all the treated animals survived for this period. Based on these results, we developed a workshop that has been used in five courses (www.ccmijesususon.com - www.crrtcordoba.com.es/), obtaining the previous results. CONCLUSIONS Our shock model shows a predictable behavior, very short latency and a sufficiently rapid improvement in the treated animals for it to be applied in training workshops. It is useful for training in the high-volume hemofiltration (HVHF) and can be used for training in the early management of septic shock.