Effects of hydrogen sulfide (H2S) on mesenteric perfusion in experimental induced intestinal ischemia in a porcine model.
BACKGROUND
Insufficient mesenteric perfusion is a dramatic complication in critically ill patients. Hydrogen sulfide, a newly recognized endogenous gaseous mediator, acts as an intestinal vasoactive agent and seems to protect against mesenteric ischemic damage. We investigated whether sodium hydrogen sulfide, a hydrogen sulfide donor, can improve mesenteric perfusion in an experimental model of pigs, both in physiological and ischemic conditions.


METHODS
The study was conducted at Careggi University Hospital (Florence, IT). Fourteen male domestic pigs (≈10 Kg) were anesthetized and mechanically ventilated. Animals were randomized in control and ischemia groups. Mesenteric ischemia was induced with a positive end-expiratory pressure of 15 cmH2O. After mini-laparotomy, each animal received incremental doses of sodium hydrogen sulfide every 20 minutes. Perfusion of both the jejunal mucosa and sternal skin were measured by laser Doppler flowmeter, and systemic hemodynamic parameters were monitored.


RESULTS
In the control group, sodium hydrogen sulfide was able to significantly improve the mesenteric perfusion, showing a 50% increase from the baseline blood flow. In the ischemia group, NaHS-induced a two-fold increase of the mesenteric post-ischemic perfusion with a recovery up to 70% of pre- positive end-expiratory pressure mesenteric blood flow. Sodium hydrogen sulfide did not directly or indirectly (by blood flow redistribution) affect the sternal skin microcirculation, heart rates, or mean arterial pressure, suggesting a tissue-specific micro-vascular action.


CONCLUSIONS
In a porcine model, we observed a mesenteric perfusion recovery mediated by administration of hydrogen sulfide donor without affecting general hemodynamic.
Department of Anesthesia, Santa Maria Nuova Hospital, Florence, Italy.
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V
Pavoni
Department of Health Sciences, Careggi University Hospital, Florence, Italy.
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P
Nicoletti
Department of Health Sciences, Careggi University Hospital, Florence, Italy.
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S
Benemei
Department of Health Sciences, Careggi University Hospital, Florence, Italy.
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S
Materazzi
Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy.
F
F
Perna
Department of Anesthesia and Intensive Care, Careggi University Hospital, Florence, Italy.
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S
Romagnoli
Department of Anesthesia and Intensive Care, Careggi University Hospital, Florence, Italy.
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C
Chelazzi
Department of Anesthesia and Intensive Care, Careggi University Hospital, Florence, Italy.
G
G
Zagli
Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy.
A
A
Coratti
hydrogen sulfide; intestinal ischemia; mesenteric perfusion