Peritoneal instillation of taurolidine or polihexanide modulates intestinal microcirculation in experimental endotoxemia.
OBJECTIVE
Treatment of peritonitis may include peritoneal lavage/instillation with anti-infective agents like taurolidine or chlorhexidine.


METHODS
We examined the effects of peritoneal instillation (INST, 5-ml solution) with taurolidine (TAURO) or polihexanide (POLI-LS) on intestinal microcirculation using intravital microscopy (IVM) in experimental endotoxemia (15 mg/kg lipopolysaccharide i.v.; LPS) in the rat (n = 8 each group), their direct effects on local small blood vessels, aortal rings, and myocardial strips in vitro, as well as plasma interleukin levels.


RESULTS
It was found that LPS produced hypotension (98.8 +/- 9.5 vs 130.4 +/- 10.5 mmHg; mean arterial pressure [MAP], mean +/- standard deviation [SD]), which was further pronounced after INST of TAURO (78.8 +/- 10.8; P < 0.005) or POLI-LS (78.1 +/- 6.0; P < 0.001). IVM revealed a reduction in temporary adhering leucocytes and an increase in firmly adhering leucocytes after INST with TAURO and POLI-LS. Both agents reduced functional capillary density either in the mucosa (POLI-LS vs sham: 259.7 +/- 54 cm/cm(2) vs 337.1 +/- 35.5) or longitudinal muscular layer in LPS rats (TAURO vs sham: 119.8 +/- 14.8 vs 153.7 +/- 11.0). POLI-LS induced local vasodilatation, whereas TAURO induced small vasoconstriction; in vitro, both agents showed vasodilating properties and did not have any effect on myocardial strip contraction.


CONCLUSIONS
Some of the observed microcirculatory changes could be a result of the direct vascular effects of these agents.
Frieling
Helge
H
Klinik und Poliklinik für Anästhesiologie und Intensivmedizin, Ernst Moritz Arndt University, Friedrich-Loeffler Str. 23B, 17487, Greifswald, Germany. pavlovic@uni-greifswald.de
Lauer
Kai-Steffen
KS
Gründling
Matthias
M
Usichenko
Taras
T
Meissner
Konrad
K
Kanellopoulou
Theoni
T
Lehmann
Christian
C
Wendt
Michael
M
Pavlovic
Dragan
D
D000818:Animals; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D001645:Biguanides / Q000008:administration & dosage*; D004195:Disease Models, Animal; D019446:Endotoxemia / Q000188:drug therapy* / Q000209:etiology; D005769:Gastrointestinal Motility / Q000187:drug effects / Q000502:physiology; D007322:Instillation, Drug; D007422:Intestines / Q000098:blood supply*; D008070:Lipopolysaccharides / Q000633:toxicity; D008297:Male; D008833:Microcirculation / Q000187:drug effects*; D010533:Peritoneal Lavage / Q000379:methods*; D051381:Rats; D011917:Rats, Inbred Lew; D013654:Taurine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013829:Thiadiazines / Q000008:administration & dosage*; D016896:Treatment Outcome; D014664:Vasodilation / Q000187:drug effects
D000891:Anti-Infective Agents, Local; D001645:Biguanides; D008070:Lipopolysaccharides; D013829:Thiadiazines; D013654:Taurine; C031233:polihexanide; C012566:taurolidine