Abstract
Cecal ligation and puncture (CLP) is referred to as the “gold standard” rodent model for abdominal sepsis. CLP creates a continuously leaking, polymicrobial infectious focus in the abdomen. The abdominal cavity is opened under general anesthesia and analgesia and the cecum is exposed, ligated underneath the ileocecal valve, and punctured with a needle. A small amount of feces is pressed out through the puncture and the cecum is repositioned into the abdomen, which is then closed with single button sutures and tissue glue. CLP severity can be influenced via the length of the ligated cecum as well as the needle size. Within 24 h, animals develop clinical signs of a systemic bacterial infection. Analgesia, wide range antibiotic treatment, and fluid resuscitation should be administered during the acute phase of sepsis to increase the clinical relevance of the CLP model.
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References
Fleischmann C, Scherag A, Adhikari NK et al (2016) Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations. Am J Respir Crit Care Med 193:259–272
Coopersmith CM, De Backer D, Deutschman CS et al (2018) Surviving sepsis campaign: research priorities for sepsis and septic shock. Intensive Care Med 44:1400–1426
Chen X, Zhu W, Tan J et al (2017) Early outcome of early-goal directed therapy for patients with sepsis or septic shock: a systematic review and meta-analysis of randomized controlled trials. Oncotarget 8:27510
Zhang L, Zhu G, Han L et al (2015) Early goal-directed therapy in the management of severe sepsis or septic shock in adults: a meta-analysis of randomized controlled trials. BMC Med 13:71
Mayr FB, Yende S, Angus DC (2014) Epidemiology of severe sepsis. Virulence 5:4–11
Angus DC, Van der Poll T (2013) Severe sepsis and septic shock. N Engl J Med 369:840–851
Alverdy J, Hyoju S, Weigerinck M et al (2017) The gut microbiome and the mechanism of surgical infection. Br J Surg 104:e14–e23
Taeb AM, Hooper MH, Marik PE (2017) Sepsis: current definition, pathophysiology, diagnosis, and management. Nutr Clin Pract 32:296–308
Dejager L, Pinheiro I, Dejonckheere E et al (2011) Cecal ligation and puncture: the gold standard model for polymicrobial sepsis? Trends Microbiol 19:198–208
Wichterman KA, Baue AE, Chaudry IH (1980) Sepsis and septic shock—a review of laboratory models and a proposal. J Surg Res 29:189–201
Ryan NT, Blackburn GL, Clowes GH Jr (1974) Differential tissue sensitivity to elevated endogenous insulin levels during experimental peritonitis in rats. Metabolism 23:1081–1089
Zolfaghari PS, Pinto BB, Dyson A et al (2013) The metabolic phenotype of rodent sepsis: cause for concern? Intensive Care Med Exp 1:6
Singleton K, Wischmeyer P (2003) Distance of cecum ligated influences mortality, tumor necrosis factor-alpha and interleukin-6 expression following cecal ligation and puncture in the rat. Eur Surg Res 35:486–491
Rittirsch D, Huber-Lang MS, Flierl MA et al (2009) Immunodesign of experimental sepsis by cecal ligation and puncture. Nat Protoc 4:31–36
Kieslichova E, Rocen M, Merta D et al (2013) The effect of immunosuppression on manifestations of sepsis in an animal model of cecal ligation and puncture. Transplant Proc 45(2):770–777
Stahl TJ, Alden PB, Ring WS et al (1990) Sepsis-induced diastolic dysfunction in chronic canine peritonitis. Am J Phys Heart Circ Phys 258:H625–H633
Zingarelli B, Coopersmith CM, Drechsler S et al (2019) Part I: minimum quality threshold in preclinical sepsis studies (MQTiPSS) for study design and humane modeling endpoints. Shock 51:10–22
Libert C, Ayala A, Bauer M et al (2019) Part II: minimum quality threshold in pre-clinical sepsis studies (MQTiPSS) for types of infections and organ dysfunction endpoints. Shock 51:23
Hellman J, Bahrami S, Boros M et al (2019) Part III: minimum quality threshold in preclinical sepsis studies (MQTiPSS) for fluid resuscitation and antimicrobial therapy endpoints. Shock 51:33–43
de Melo CD, de Oliveira Lopes LK, Hu H et al (2017) Alcohol fixation of bacteria to surgical instruments increases cleaning difficulty and may contribute to sterilization inefficacy. Am J Infect Control 45:e81–e86
Iskander KN, Vaickus M, Duffy ER et al (2016) Shorter duration of post-operative antibiotics for Cecal ligation and puncture does not increase inflammation or mortality. PLoS One 11:e0163005
Huet O, Ramsey D, Miljavec S et al (2013) Ensuring animal welfare while meeting scientific aims using a murine pneumonia model of septic shock. Shock 39:488–494
Shrum B, Anantha RV, Xu SX et al (2014) A robust scoring system to evaluate sepsis severity in an animal model. BMC Res Notes 7:233
Nemzek JA, Hugunin KM, Opp MR (2008) Modeling sepsis in the laboratory: merging sound science with animal well-being. Comp Med 58:120–128
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Drechsler, S., Osuchowski, M. (2021). Cecal Ligation and Puncture. In: Walker, W.E. (eds) Sepsis. Methods in Molecular Biology, vol 2321. Humana, New York, NY. https://doi.org/10.1007/978-1-0716-1488-4_1
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DOI: https://doi.org/10.1007/978-1-0716-1488-4_1
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