The effects of ischemia and ischemia-reperfusion on bacterial translocation, lipid peroxidation, and gut histology: studies on hemorrhagic shock in pigs.
The bacterial translocation hypothesis was tested in two studies (acute and subacute) in a porcine model of hemorrhagic shock. Male pigs (30-40 kg each) under general anesthesia had their femoral vein, femoral artery, and portal vein catheterized. After stabilization (1 hour) they were bled (40% of blood volume) over 30 minutes, then maintained in the hypotensive state (MAP = 30-40 mm Hg) for 2 hours, following which, according to randomization, they entered the control group or were resuscitated with whole blood (WB group) or with lactated Ringer's solution (LR group). In the acute study, the mesenteric efferent lymphatic was also cannulated, the control group was not resuscitated, and the animals remained under general anesthesia to the end of the experiment (8.5 hours), when gut tissue was obtained for histologic study and measurement of lipid peroxidation. In the subacute study, the control group was not bled, the animals were awakened at 6.5 hours, and the portal vein catheter remained in situ until 48 hours. In both studies, samples of portal blood were obtained for culture at regular intervals and on completion, samples from mesenteric lymph nodes (MLNs) for culture were taken in the acute study, and in the subacute study samples from MLNs, spleen, and liver were obtained. In the acute study significant bacterial translocation to the MLNs and portal blood did not occur among the controls (n = 3), the LR group (n = 5), and the WB group (n = 6). Significant evidence of lipid peroxidation was found in both the LR and WB groups. Histologic assessment showed no difference among the groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Morales
J
J
Department of Surgery, University of Alberta, Edmonton, Canada.
Kibsey
P
P
Thomas
P D
PD
Poznansky
M J
MJ
Hamilton
S M
SM
D000818:Animals; D016470:Bacteremia / Q000097:blood; D001804:Blood Transfusion, Autologous; D004755:Enterobacteriaceae / Q000502:physiology*; D006439:Hemodynamics; D007413:Intestinal Mucosa / Q000382:microbiology* / Q000473:pathology; D007422:Intestines / Q000382:microbiology* / Q000473:pathology; D007552:Isotonic Solutions / Q000627:therapeutic use; D015227:Lipid Peroxidation; D008099:Liver / Q000382:microbiology; D008196:Lymph / Q000382:microbiology; D008297:Male; D008643:Mesentery; D011897:Random Allocation; D015427:Reperfusion Injury / Q000473:pathology / Q000503:physiopathology*; D000077325:Ringer's Lactate; D012771:Shock, Hemorrhagic / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D013154:Spleen / Q000382:microbiology; D013552:Swine
D007552:Isotonic Solutions; D000077325:Ringer's Lactate