Splanchnic vasoconstriction and bacterial translocation after thermal injury.
Gut barrier failure and bacterial translocation (BT) after thermal injury may result from splanchnic vasoconstriction and intestinal ischemia. The role of the renin-angiotensin system in intestinal blood flow and BT after thermal injury was studied by pretreatment with the angiotensin-converting enzyme (ACE) inhibitor enalapril in Wistar rats before sham or 30% scald burn. Adequacy of ACE inhibition was documented by the absence of a hypertensive response to angiotensin I, and intestinal blood flow was determined using 51Cr-labeled microspheres. Small bowel blood flow was decreased by 46% at 4-h postburn (P less than 0.05) in untreated burned animals despite maintenance of normal cardiac index but returned to baseline levels by 24 h after injury. Enalapril pretreatment resulted in maintenance of small bowel blood flow after thermal injury and was associated with a significantly reduced incidence of BT (20% vs. 75% in untreated burned animals, P less than 0.01). These findings further implicate intestinal ischemia in the etiology of gut barrier dysfunction after thermal injury, mediated in part by activation of the renin-angiotensin system.
Department of Surgery, Cornell University Medical College, New York, New York 10021.
W G
WG
Jones
J P
JP
Minei
A E
AE
Barber
T J
TJ
Fahey
G T
GT
Shires
G T
GT
Shires
D000818:Animals; D018407:Bacterial Physiological Phenomena; D001794:Blood Pressure / Q000187:drug effects; D002056:Burns / Q000382:microbiology / Q000503:physiopathology*; D002302:Cardiac Output / Q000187:drug effects; D002465:Cell Movement / Q000187:drug effects; D004656:Enalapril / Q000494:pharmacology; D006339:Heart Rate / Q000187:drug effects; D007421:Intestine, Small / Q000098:blood supply / Q000382:microbiology; D008297:Male; D051381:Rats; D011919:Rats, Inbred Strains; D012039:Regional Blood Flow; D013152:Splanchnic Circulation; D014655:Vascular Resistance / Q000187:drug effects; D014661:Vasoconstriction
D004656:Enalapril