title: Enoxaparin sodium prevents intestinal microcirculatory dysfunction in endotoxemic rats.
abstract: BACKGROUND
  During severe sepsis or septic shock, activation of the inflammatory and coagulatory systems can result in microcirculatory dysfunction as well as microvascular thrombosis, culminating in multiple organ dysfunction and death. Enoxaparin can inhibit factor Xa and attenuate endothelial damage. The primary purpose of this study was to investigate the effect of enoxaparin on intestinal microcirculation in endotoxemic rats.
  
  
  METHODS
  Thirty male Wistar rats were divided into the following three groups: sham operated (OP); lipopolysaccharide (LPS); and LPS + Enoxaparin group. The rats received a midline laparotomy to exteriorize a segment of terminal ileum for microcirculation examination by full-field laser perfusion imager and sidestream dark field video microscope on mucosa, muscle, and Peyer's patch. In the LPS and LPS + Enoxaparin groups, 15 mg/kg LPS was administered intravenously to induce endotoxemia, and 400 IU/kg enoxaparin sodium was also administered in the LPS + Enoxaparin group.
  
  
  RESULTS
  At 240 minutes, the mean arterial pressure was higher in the LPS + Enoxaparin group than in the LPS group (93 ± 9 versus 64 ± 16 mm Hg, P < 0.001). Microcirculatory blood flow intensity was higher in the LPS + Enoxaparin group than in the LPS group as follows: mucosa (1085 ± 215 versus 617 ± 214 perfusion unit [PU], P < 0.001); muscle (760 ± 202 versus 416 ± 223 PU, P = 0.001); and Peyer's patch (1,116 ± 245 versus 570 ± 280 PU, P < 0.001). Enoxaparin inhibited LPS-induced reduction in perfused small vessel density and increase in heterogeneity of microcirculation.
  
  
  CONCLUSIONS
  Enoxaparin can prevent intestinal microcirculatory dysfunction in endotoxemic rats by preventing microvascular thrombosis formation and maintaining normal mean arterial pressure.
authors.affiliation: Department of Anesthesiology, National Taiwan University Hospital, No, 7, Chung-Shan S. Road, Taipei, Taiwan.
authors.forename: Yu-Chang
authors.initials: YC
authors.lastname: Yeh
authors.forename: Ming-Jiuh
authors.initials: MJ
authors.lastname: Wang
authors.forename: Chih-Peng
authors.initials: CP
authors.lastname: Lin
authors.forename: Shou-Zen
authors.initials: SZ
authors.lastname: Fan
authors.forename: Jui-Chang
authors.initials: JC
authors.lastname: Tsai
authors.forename: Wei-Zen
authors.initials: WZ
authors.lastname: Sun
authors.forename: Wen-Je
authors.initials: WJ
authors.lastname: Ko
mesh_terms: D000818:Animals; D001783:Blood Flow Velocity / Q000187:drug effects; D019446:Endotoxemia / Q000503:physiopathology*; D017984:Enoxaparin / Q000494:pharmacology*; D006439:Hemodynamics; D007422:Intestines / Q000098:blood supply*; D008070:Lipopolysaccharides; D008297:Male; D008833:Microcirculation / Q000187:drug effects*; D051381:Rats; D017208:Rats, Wistar; D018709:Statistics, Nonparametric
chemical_list: D017984:Enoxaparin; D008070:Lipopolysaccharides