title: Resuscitation with hydroxyethyl starch 130/0.4 attenuates intestinal injury in a rabbit model of sepsis.
abstract: OBJECTIVE
  Improvement of mucosal barrier function and reduction of bacterial translocation are important in the management of sepsis. The mechanisms that underlie the protective effects of colloids on the intestinal mucosal barrier are unclear. The study aims to investigate the effect of fluid resuscitation with hydroxyethyl starch (HES) 130/0.4 against intestinal mucosal barrier dysfunction in a rabbit model of sepsis.
  
  
  METHODS
  Thirty healthy rabbits were randomly and equally divided into a sham-operated control, a sepsis model, or a sepsis + HES treatment group. The sepsis model and sepsis + HES treatment groups were subjected to a modified colon ascendens stent peritonitis (CASP) procedure to induce sepsis. Four hours after the CASP procedure, fluid resuscitation was performed with 6% HES 130/0.4. Arterial and superior mesenteric vein blood samples were collected 4 and 8 h after the CASP procedure for blood gas analysis and measuring tumor necrosis factor-α, interleukin-10, and D-lactate levels. The rabbits were euthanized 8 h after CASP, and sections of the small intestine were stained to evaluate histopathological changes.
  
  
  RESULTS
  Respiratory rate and blood pressure were stable during the resuscitation period. Fluid resuscitation with 6% HES 130/0.4 alleviated pathological changes in the abdominal cavity, improved blood gas parameters and inflammatory mediator levels, decreased plasma D-lactate levels, and reduced intestinal mucosal injury compared with the non-treated sepsis model.
  
  
  CONCLUSIONS
  Fluid resuscitation with 6% HES 130/0.4 protects against intestinal mucosal barrier dysfunction in rabbits with sepsis, possibly via mechanisms associated with improving intestinal oxygen metabolism and reducing the release of inflammatory mediators.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, China.
authors.forename: Wei-Hua
authors.initials: WH
authors.lastname: Lu
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, China.
authors.forename: Xiao-Ju
authors.initials: XJ
authors.lastname: Jin
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, China.
authors.forename: Xiao-Gan
authors.initials: XG
authors.lastname: Jiang
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, China.
authors.forename: Jing-Yi
authors.initials: JY
authors.lastname: Wu
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, China.
authors.forename: Guang-Gui
authors.initials: GG
authors.lastname: Shen
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D004195:Disease Models, Animal; D005440:Fluid Therapy / Q000379:methods*; D006439:Hemodynamics; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage*; D018836:Inflammation Mediators / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D007410:Intestinal Diseases / Q000097:blood / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D007413:Intestinal Mucosa / Q000378:metabolism / Q000473:pathology*; D007421:Intestine, Small / Q000378:metabolism / Q000473:pathology*; D019344:Lactic Acid / Q000097:blood; D008297:Male; D010539:Permeability; D010952:Plasma Substitutes / Q000008:administration & dosage*; D011817:Rabbits; D012151:Resuscitation / Q000379:methods*; D018805:Sepsis / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; D006895:Hydroxyethyl Starch Derivatives; D018836:Inflammation Mediators; D010952:Plasma Substitutes; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D019344:Lactic Acid
keywords: HES 130/0.4; inflammatory mediators; intestinal mucosal barrier; resuscitation; sepsis
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