Intestinal ischemia reperfusion injury and multisystem organ failure.
Intestinal ischemia-reperfusion is a common pathway for many diseases in infants, children, and adults, and this may lead to multiple organ dysfunction syndrome and death. While several studies have investigated reperfusion injury in cardiac, cerebral, and hepatic disease, limited work has been published on intestinal ischemia-reperfusion and its multiorgan effects. The authors have developed models of intestinal ischemia-reperfusion in rats and have demonstrated that intestinal reperfusion causes liver energy failure at normothermia. This is followed by 100% mortality within 4 hours of reperfusion. Moderate hypothermia (32 degrees C to 33 degrees C) induced throughout ischemia and reperfusion prevents liver energy failure, intestinal damage, and neutrophil infiltration in the lungs. Moderate hypothermia in this model of intestinal ischemia and reperfusion prevents mortality. Further studies are needed to establish whether therapeutic hypothermia is a useful intervention in the treatment of infants and children with intestinal injuries caused by ischemia and reperfusion.
Pierro
Agostino
A
Department of Paediatric Surgery, The Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, University College London, London, UK.
Eaton
Simon
S
D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D004734:Energy Metabolism; D006331:Heart Diseases / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D007036:Hypothermia, Induced; D007422:Intestines / Q000098:blood supply*; D008099:Liver / Q000378:metabolism; D017093:Liver Failure / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D023421:Models, Animal; D020556:Neutrophil Infiltration; D051381:Rats; D015427:Reperfusion Injury / Q000150:complications*; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000378:metabolism / Q000628:therapy
D000255:Adenosine Triphosphate