title: Intestinal microcirculatory flow alterations in necrotizing enterocolitis are improved by direct peritoneal resuscitation.
abstract: Vasoconstriction of the neonatal intestinal microvasculature is a central mechanistic event in development of necrotizing enterocolitis. We hypothesized that topical treatment of the intestine with dialysate fluid would ameliorate the vasoconstriction in necrotizing enterocolitis (NEC).  NEC was induced in experimental groups. Control animals were delivered vaginally and dam-fed (control group). Neonatal pups underwent laser Doppler flow study of the terminal ileum to determine real-time blood flow in the intestinal microvasculature. After baseline flow was determined, dialysis  solution was added to the peritoneal cavity and alterations in microcirculation were recorded. Baseline ileal blood flow in the control group was significantly higher than in NEC rat pups at 48 hours post delivery (P < 0.05), but not at 24 hours (P = NS). Ileal blood flow  increased in all groups after adding dialysate (P < 0.05), improving ileal blood flow in the 48-hour NEC group and reaching the baseline level of the 48-hour control group (P < 0.05). Our data shows blood flow to be higher in 48-hour controls as compared with 24-hour controls  suggesting a time-dependency in the development of intestinal vasoregulatory processes. All groups had an increase in blood flow with dialysate treatment. This may represent a novel initial therapy to improve intestinal ischemia in human necrotizing enterocolitis.
authors: Robley Rex Veterans Affairs Medical Center, and the Department of Surgery, and Division of Pediatric Surgery, University of Louisville, Louisville, Kentucky 40202, USA.
authors: Alexandra C
authors: AC
authors: Maki
authors: Paul J
authors: PJ
authors: Matheson
authors: Jessica A
authors: JA
authors: Shepherd
authors: R Neal
authors: RN
authors: Garrison
authors: Cynthia D
authors: CD
authors: Downard
mesh_terms: D000818:Animals; D015314:Dialysis Solutions / Q000494:pharmacology / Q000627:therapeutic use*; D004195:Disease Models, Animal; D020345:Enterocolitis, Necrotizing / Q000188:drug therapy* / Q000503:physiopathology; D007082:Ileum / Q000098:blood supply* / Q000187:drug effects; D007263:Infusions, Parenteral; D008833:Microcirculation / Q000187:drug effects*; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D012151:Resuscitation / Q000379:methods*; D013997:Time Factors; D014661:Vasoconstriction / Q000187:drug effects
chemical_list: D015314:Dialysis Solutions