The effect of transient intestinal ischemia on inflammatory parameters.
OBJECTIVE
To determine the early biological changes occurring in intestinal ischemia in vivo.


METHODS
We studied the effects of acute transient intestinal ischemia in 15 patients undergoing elective open surgery for the treatment of abdominal subrenal aortic aneurysm induced by clamping of the aorta at subrenal level and above the branching of the inferior mesenteric artery. Blocking the blood flow results in hypoperfusion of the inferior mesenteric artery and then to rectal mucosal ischemia.


RESULTS
With the introduction of a mucosal ischemic period the basal intestinal mucosal pH decreased during ischemia, and showed a rapid increase during reperfusion to the level preceding ischemia. Parameters were evaluated in blood taken from inferior mesenteric vein. A rectal dialysis was put into the rectum to evaluate eicosanoid concentrations in rectal fluid collected before and during clamping and after declamping. Significant enhancement in plasma level of xanthine, a marker for tissue damage, was observed during reperfusion. Interleukin-6 levels were significantly elevated from 11.28+/-3.4 pg/ml (preischemic) to 109+/-85.9 pg/ml (ischemic) and to 189.33+/-120.24 pg/ml (reperfusion); and tromboxane B(2) levels from 141.57+/-51.20 pg/ml preoperation to 473.01+/-319.01 pg/ml during the surgical procedure.


CONCLUSIONS
These observations indicate that even transient ischemia modifies the inflammatory pattern.
Lammers
K M
KM
Department of Internal Medicine and Gastroenterology, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
Innocenti
G
G
Venturi
A
A
Rizzello
F
F
Helwig
U
U
Bianchi
G P
GP
Pedrini
L
L
Di Nino
G
G
Gionchetti
P
P
Campieri
M
M
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000097:blood; D015415:Biomarkers / Q000097:blood; D017091:Colitis, Ischemic / Q000097:blood*; D016207:Cytokines / Q000097:blood; D015777:Eicosanoids / Q000097:blood; D006801:Humans; D019271:Hypoxanthine / Q000097:blood; D018836:Inflammation Mediators / Q000097:blood*; D007413:Intestinal Mucosa / Q000378:metabolism; D007558:Italy; D007958:Leukocyte Count; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism; D010587:Phagocytosis / Q000502:physiology; D015424:Reperfusion; D013525:Surgical Instruments; D019820:Xanthine / Q000097:blood; D014969:Xanthine Oxidase / Q000097:blood; D014841:von Willebrand Factor / Q000378:metabolism
D015415:Biomarkers; D016207:Cytokines; D015777:Eicosanoids; D018836:Inflammation Mediators; D014841:von Willebrand Factor; D019820:Xanthine; D019271:Hypoxanthine; D014969:Xanthine Oxidase