Die komplette Dissertation im pdf-Format :
In this study the effect of rhG-CSF on the Gram-negative sepsis in the not
sedated pig were investigated. The clinical course, hemodynamic parameters,
the blood gas conditions and different mediators were considered. For a
simulation of the clinical situation the growth factor was given 3 hours after
the induction of a P. aeruginosa septicemia and repeated every 24 h
afterwards. We used 7 animals in the G-CSFgroup and 10 in the control group.
The observation period was appointed to 120 hours. 5 animals of the G-CSF
group and 5 of the controls attained the endpoint (71 % and 50 %
respectively). Those animals who received the growth factor, responded within
24 h of the first application with a increased leukocyte count in the
peripheral blood compared with the control. The level reached 140 % of the
baseline count in this group. Apart from these increase we could not ascertain
any significant distinctions in the investigated parameters between the
control and the G-CSF group.
The neutrophilic granulocyte are valid as the main effectors of the organ
injury in a septicemic disorder. In these occurence they are stimulated by the
mediators endotoxin, TNF-?, IL-1 and others to adhesion and emigration in the
tissue as well as to the production and liberation of cytotoxic enzymes and
radicals. This is primary manifestated in the lung.
In the investigated G-CSF group the leukocyte count increased in the last
phase up to 162 % of the control level. Nevertheless we could not find out any
enhanced lung injuries. Presumable this is mainly caused by the changed
reactions of the induced granulocytes, wich are sure stimulated by the growth
hormone, but which as well shed the adhesion molecules CD62L from their
surface, so that they are less adhesive to the endothelium.
So with the therapeutical application of G-CSF in the non-neutropenic pig we
could not show any negative effects, but we also do not have benefit to the
Gram-negative sepsis. By this aspect and in consideration of the high costs of
such an additive therapy one should do without G-CSF in the non-neutropenic
patient with Pseudomonas sepsis.
600 Technik, Medizin, angewandte Wissenschaften::630 Landwirtschaft::630 Landwirtschaft und verwandte Bereiche
Therapie der Pseudomonas aeruginosa-Sepsis mit rhG-CSF (Filgrastim) unter
besonderer Berücksichtigung der hämodynamischen Veränderungen und des
klinischen Verlaufes : eine experimentelle Studie am nicht anästhesierten,
invasiv instrumentierten Schwein
Univ.-Prof. Dr. L. Brunnberg
PD Dr. J. Haberstroh
Pseudomonas aeruginosa sepsis in the non-anesthetized pig: effect of the
granulocyte colony-stimulating factor Filgrastim on hemodynamic and clinical