Hypertonic Saline Solution Reduces Intestinal Bacterial Translocation in a Rat Model of Intestinal Obstruction and Ischemia
F.L. Zanoni1; K.V. Greco2; A.C.R. Moreno3; M.B. Martinez3; L.F. Poli de Figueiredo1; M. Rocha e Silva1; P. Sannomiya1
Supported by FAPESP (Process #04/15964-6) and Pronex/CNPq (Process #66.11251998-2).
Bacterial translocation (BT) has been shown to occur in critically ill patients after extensive trauma, shock, sepsis, or thermal injury. Conditions associated with splanchnic hypoperfusion, such as hemorrhagic shock or intestinal ischemia, result in the gut becoming a cytokine-generating organ, followed by intestinal mucosal injury and loss of gut-barrier function. The aim of this study is to evaluate the effects of hypertonic saline (HSS) 7.5% and lactated Ringer´s (LR) solutions on intestinal BT in rats that underwent intestinal obstruction and ischemia (IO). Wistar rats were submitted to IO: 1) cecum exposure, 2) ileum ligation at 1.5 cm proximal to the ileocecal valve, 3) and ligation of the mesenteric vessels that supply 7-10 cm length of ileal loop. Two hours after surgical procedures, 4 mL/kg of 7,5% HSS or LR were administered intravenously, during 5 minutes. Animals were killed 24 h after IO, and microbiological assays were performed in mesenteric lymph nodes, liver, spleen, and blood. Serum levels of urea, creatinine, hepatic enzymes and bilirubin, blood glucose and lactate levels were determined by routine techniques. About 86% of IO rats presented positive cultures for E. coli in samples of mesenteric lymph nodes, liver and spleen, and 57% had positive hemocultures. Animals also presented hyperglycemia and hyperlactatemia, as well increases in serum urea, creatinine, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and bilirubin levels. HSS reduced the number of animals with positive cultures in liver (43%), spleen (71%) and blood (14%) samples, blood glucose and lactate levels, and serum levels of creatinine, ALT, and ALP. In conclusion, HSS reduced BT and blood levels of hepatic enzymes, glucose and other substances, suggesting an improvement of the gut barrier function and reduction of remote organ damage.