BMC Gastroenterology | |
Effects of crystalloids and colloids on liver and intestine microcirculation and function in cecal ligation and puncture induced septic rodents | |
Research Article | |
Tanja Stueber1  Jan Stumpner1  Norbert Roewer1  Christian Wunder1  Juergen Brugger1  Martin Alexander Schick1  Jobst Tobias Isbary1  Otto Eichelbroenner2  Nicolas Schlegel3  | |
[1] Department of Anaesthesia and Critical Care, University of Würzburg, Oberdürrbacherstraße 6, 97080, Würzburg, Germany;Department of Anaesthesiology and Critical Care, Clinic of Chemnitz gGmbH, Flemmingstraße 2, 09116, Chemnitz, Germany;Department of General, Visceral, Vascular and Paediatric Surgery (Department of Surgery II), University of Würzburg, Oberdürrbacherstraße 6, 97080, Würzburg, Germany; | |
关键词: Sepsis; Microcirculation; Colloids; HES; Crystalloids; | |
DOI : 10.1186/1471-230X-12-179 | |
received in 2012-07-23, accepted in 2012-12-11, 发布年份 2012 | |
来源: Springer | |
【 摘 要 】
BackgroundSeptic 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.MethodsSepsis 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.ResultsHES 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.ConclusionsGelatine 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】
Unknown
© Schick et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
【 预 览 】
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