Effects of crystalloids and colloids on liver and intestine microcirculation and function in cecal ligation and puncture induced septic rodents

BMC Gastroenterology

Christian Wunder²  Otto Eichelbroenner³  Norbert Roewer²  Nicolas Schlegel¹  Jan Stumpner²  Juergen Brugger²  Tanja Stueber²  Jobst Tobias Isbary²  Martin Alexander Schick² 

[1] Department of General, Visceral, Vascular and Paediatric Surgery (Department of Surgery II), University of Würzburg, Oberdürrbacherstraße 6, Würzburg, 97080, Germany;Department of Anaesthesia and Critical Care, University of Würzburg, Oberdürrbacherstraße 6, Würzburg, 97080, Germany;Department of Anaesthesiology and Critical Care, Clinic of Chemnitz gGmbH, Flemmingstraße 2, Chemnitz, 09116, Germany

关键词: Crystalloids;    HES;    Colloids;    Microcirculation;    Sepsis;   

Others  :  858263
DOI  :  10.1186/1471-230X-12-179

 received in 2012-07-23, accepted in 2012-12-11,  发布年份 2012

【 摘 要 】

Background

Septic acute liver and intestinal failure is associated with a high mortality. We therefore investigated the influence of volume resuscitation with different crystalloid or colloid solutions on liver and intestine injury and microcirculation in septic rodents.

Methods

Sepsis was induced by cecal ligation and puncture (CLP) in 77 male rats. Animals were treated with different crystalloids (NaCl 0.9% (NaCl), Ringer’s acetate (RA)) or colloids (Gelafundin 4% (Gel), 6% HES 130/0.4 (HES)). After 24 h animals were re-anesthetized and intestinal (n = 6/group) and liver microcirculation (n = 6/group) were obtained using intravital microscopy, as well as macrohemodynamic parameters were measured. Blood assays and organs were harvested to determine organ function and injury.

Results

HES improved liver microcirculation, cardiac index and DO₂-I, but significantly increased IL-1β, IL-6 and TNF-α levels and resulted in a mortality rate of 33%. Gel infused animals revealed significant reduction of liver and intestine microcirculation with severe side effects on coagulation (significantly increased PTT and INR, decreased haemoglobin and platelet count). Furthermore Gel showed severe hypoglycemia, acidosis and significantly increased ALT and IL-6 with a lethality of 29%. RA exhibited no derangements in liver microcirculation when compared to sham and HES. RA showed no intestinal microcirculation disturbance compared to sham, but significantly improved the number of intestinal capillaries with flow compared to HES. All RA treated animals survided and showed no severe side effects on coagulation, liver, macrohemodynamic or metabolic state.

Conclusions

Gelatine 4% revealed devastated hepatic and intestinal microcirculation and severe side effects in CLP induced septic rats, whereas the balanced crystalloid solution showed stabilization of macro- and microhemodynamics with improved survival. HES improved liver microcirculation, but exhibited significantly increased pro-inflammatory cytokine levels. Crystalloid infusion revealed best results in mortality and microcirculation, when compared with colloid infusion.

【 授权许可】

   
2012 Schick et al.; licensee BioMed Central Ltd.

【 图 表 】

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