Protein C preserves microcirculation in a model of neonatal septic shock

Figures & data

Table 1 Blood cell counts

	Hb (g/dl) baseline	Hb (g/dl) 180 min	Hct (%) baseline	Hct (%) 180 min	PLT (/nl) baseline	PLT (/nl) 180 min	WBC(/nl) baseline	WBC (/nl) 180 min
Vehicle	6.86 ± 2.79	6.47 ± 0.3	21.4 ± 9.37	20.6 ± 2.62	766 ± 215	587 ± 230	8.08 ± 2.19	4.27 ± 1.66
rhAPC	5.98 ± 0.58	6.7 ± 0.81	17.9 ± 2.25	19.7 ± 2.17	845 ± 189	635 ± 266	7.84 ± 1.67	4.6 ± 0.97

Notes: All values shown as mean ± standard error of the mean. No statistically significant differences between controls and rhAPC were found. Baseline was set at t0, ie, immediately prior to LPS injection.

Abbreviations: Hb, hemoglobin; Hct, hematocrit; PLT, platelets; rhAPC, recombinant activated protein C.

Figure 1 Macro- and microcirculatory effects of recombinant activated protein C (rhAPC). Endotoxic shock was induced by injection of 500 μg/kg LPS in 10 piglets at t0 (0 min). A continuous infusion of 24 μg/kg/hrhAPC(five animals, black circles) or vehicle (five animals, open circles) was started at 30 min.

Notes: All values shown as mean ± standard error of the mean. #, p < 0.05 for controls at later time points vs controls at 0 min. §, p < 0.05 for rhAPC-treated piglets vs controls. A) mean arterial blood pressure (MAP) in mmHg. B) functional capillary density (FCD) in cm/cm². C) red blood cell velocity (VRBC) in μm/sec. D) red blood cell flow (FRBC)in μm³/sec.

Figure 2 Amelioration of LPS-induced impairment of microcirculation. Microcirculation was assessed half-hourly by OPS-microscopy at three sites of the intestine in each of 10 piglets which had received 500 μg/kg LPS. The video sequences obtained during the three-hour study period were independently assessed by four blinded investigators using a semiquantitative scoring system. After having seen one representative video for each category, they applied the following scores to 18 sequences: score 0, no visible capillaries; score 1, very few visible capillaries, low velocity or no visible blood cell flow; score 2, some visible capillaries, moderate velocity, visible blood cell flow; score 3, many visible capillaries, high velocity, blood cell flow obvious.

Notes: The mean scores are shown in the figure: ± SEM; five piglets per group, four blinded assessors, and 18 videos; ***p < 0.001 for rhAPC- vs vehicle-treated piglets. Abbreviations: rhAPC, recombinant activated protein C; LPS, lipopolysaccharides; OPS, orthogonal polarization spectral imaging.