Postconditioning of the small intestine: which is the most effective algorithm in a rat model?

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• 作者：Oliver Rosero ; MD^a ; ^{oliveross@gmail.com" class="auth_mail} ; Peter Onody ; MD^a ; Rita Stangl ; MD^a ; Zsolt Turoczi ; MD^a ; Andras Fulop ; MD^a ; David Garbaisz ; MD^a ; Gabor Lotz ; MD ; PhD^b ; Laszlo Harsanyi ; MD ; PhD^a ; Attila Szijarto ; MD ; PhD^a
• 关键词：Intestinal ischemia ; Reperfusion injury ; Postconditioning algorithms ; Mucosal microcirculation ; Rat
• 刊名：Journal of Surgical Research
• 出版年：April, 2014
• 年：2014
• 卷：187
• 期：2
• 页码：427-437
• 全文大小：2119 K

文摘

Background

Mesenteric ischemia is a serious clinical condition requiring immediate surgical intervention. The unavoidable ischemic-reperfusion (IR) injury may be ameliorated using the appropriate postconditioning protocol. The aim of the present study was to investigate the optimal postconditioning algorithm in a rat model of intestinal ischemic-reperfusion injury.

Materials and methods

Male Wistar rats were randomized into five groups (n聽=聽10), one sham-operated, one IR, and three postconditioned groups, each with different protocols. The animals were subjected to 60聽min of mesenteric ischemia, followed by 60聽min of reperfusion. Postconditioning was applied at the onset of reperfusion using three different algorithms. Arterial pressure and mucosal microcirculation were monitored throughout the experiment. Mesenteric pH was determined at the early phase of reperfusion. Blood and tissue samples were taken at the end of reperfusion for histologic evaluation, serum lactate dehydrogenase, serum creatine kinase, serum tumor necrosis factor-伪, serum interleukin-6, detailed mucosal antioxidant, and scavenger capacity assays.

Results

The shorter and intermediate length cycles of postconditioning enhanced mucosal microcirculation and redox state and significantly delayed the normalization of mesenteric pH. Furthermore, milder histopathologic lesions and lower concentrations of serum necroenzymes and proinflammatory cytokines were detected compared with the IR group. The protective effect of postconditioning using longer cycles could only be seen in a tendentious manner.

Conclusions

In a rat model of intestinal ischemia-reperfusion, the shorter and intermediate length cycles of postconditioning proved to be more effective than the use of longer cycles.