Influence of two different levels of intra-abdominal hypertension on bacterial translocation in a porcine model
Identifieur interne : 000755 ( Main/Exploration ); précédent : 000754; suivant : 000756Influence of two different levels of intra-abdominal hypertension on bacterial translocation in a porcine model
Auteurs : Torsten Kaussen [Allemagne] ; Pramod Kadaba Srinivasan [Allemagne] ; Mamdouh Afify [Allemagne] ; Christiane Herweg [Allemagne] ; René Tolba [Allemagne] ; Joachim Conze [Allemagne] ; Alexander Schachtrupp [Allemagne]Source :
- Annals of Intensive Care [ 2110-5820 ] ; 2012.
Abstract
The purpose of the present study was to quantify bacterial translocation to mesenteric lymph nodes due to different levels of intra-abdominal hypertension (IAH; 15 vs. 30 mmHg) lasting for 24 h in a porcine model.
We examined 18 anesthetized and intubated pigs (52.3 ± 4.7 kg) which were randomly allocated to three experimental groups (each
Cardiac output decreased in all groups. In IAP-30 animals, volumetric preload indices significantly decreased, while those of IAP-15 pigs did not differ from those of controls. Under IAH, the mean arterial pressure (MAP) in the IAP-30 group declined, while MAP in the IAP-15 group was significantly elevated (controls unchanged). PO2 and PCO2 remained unchanged. The grade of ischemic damage of the intestines (histopathologically quantified using the Park score) increased significantly with different IAH levels. Accordingly, the amount of translocated bacteria in intestinal wall specimens as well as in MLN significantly increased with the level of IAH. Lymph node cultures confirmed the relation between bacterial translocation (BT) and IAP. The most often cultivated species were
In this porcine model, a higher level of ischemic damage and more BT were observed in animals subjected to an IAP of 30 mmHg when compared to animals subjected to an IAP of 15 mmHg or controls.
Url:
DOI: 10.1186/2110-5820-2-S1-S17
PubMed: 22873417
PubMed Central: 3390291
Affiliations:
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Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Insitute of Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Aix-la-Chapelle</settlement></placeName></affiliation></author><author><name sortKey="Herweg, Christiane" sort="Herweg, Christiane" uniqKey="Herweg C" first="Christiane" last="Herweg">Christiane Herweg</name><affiliation wicri:level="3"><nlm:aff id="I2">Insitute of Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Insitute of Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen</wicri:regionArea><placeName><region type="land" 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first="Joachim" last="Conze">Joachim Conze</name><affiliation wicri:level="3"><nlm:aff id="I3">Department of Surgery, RWTH Aachen University, Pauwelsstr. 30, 52070 Aachen, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Surgery, RWTH Aachen University, Pauwelsstr. 30, 52070 Aachen</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Aix-la-Chapelle</settlement></placeName></affiliation></author><author><name sortKey="Schachtrupp, Alexander" sort="Schachtrupp, Alexander" uniqKey="Schachtrupp A" first="Alexander" last="Schachtrupp">Alexander Schachtrupp</name><affiliation wicri:level="3"><nlm:aff id="I3">Department of Surgery, RWTH Aachen University, Pauwelsstr. 30, 52070 Aachen, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Surgery, RWTH Aachen University, Pauwelsstr. 30, 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type="wicri:Area/Main/Exploration">000755</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Influence of two different levels of intra-abdominal hypertension on bacterial translocation in a porcine model</title><author><name sortKey="Kaussen, Torsten" sort="Kaussen, Torsten" uniqKey="Kaussen T" first="Torsten" last="Kaussen">Torsten Kaussen</name><affiliation wicri:level="3"><nlm:aff id="I1">Department of Pediatric Cardiology and Intensive Care, University Children's Hospital, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Pediatric Cardiology and Intensive Care, University Children's Hospital, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover</wicri:regionArea><placeName><region type="land" nuts="2">Basse-Saxe</region><settlement type="city">Hanovre</settlement></placeName></affiliation></author><author><name sortKey="Srinivasan, Pramod Kadaba" sort="Srinivasan, Pramod Kadaba" uniqKey="Srinivasan P" first="Pramod Kadaba" last="Srinivasan">Pramod Kadaba Srinivasan</name><affiliation wicri:level="3"><nlm:aff id="I2">Insitute of Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Insitute of Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Aix-la-Chapelle</settlement></placeName></affiliation></author><author><name sortKey="Afify, Mamdouh" sort="Afify, Mamdouh" uniqKey="Afify M" first="Mamdouh" last="Afify">Mamdouh Afify</name><affiliation wicri:level="3"><nlm:aff id="I2">Insitute of Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Insitute of Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Aix-la-Chapelle</settlement></placeName></affiliation></author><author><name sortKey="Herweg, Christiane" sort="Herweg, Christiane" uniqKey="Herweg C" first="Christiane" last="Herweg">Christiane Herweg</name><affiliation wicri:level="3"><nlm:aff id="I2">Insitute of Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Insitute of Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Aix-la-Chapelle</settlement></placeName></affiliation></author><author><name sortKey="Tolba, Rene" sort="Tolba, Rene" uniqKey="Tolba R" first="René" last="Tolba">René Tolba</name><affiliation wicri:level="3"><nlm:aff id="I2">Insitute of Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Insitute of Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Aix-la-Chapelle</settlement></placeName></affiliation></author><author><name sortKey="Conze, Joachim" sort="Conze, Joachim" uniqKey="Conze J" first="Joachim" last="Conze">Joachim Conze</name><affiliation wicri:level="3"><nlm:aff id="I3">Department of Surgery, RWTH Aachen University, Pauwelsstr. 30, 52070 Aachen, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Surgery, RWTH Aachen University, Pauwelsstr. 30, 52070 Aachen</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Aix-la-Chapelle</settlement></placeName></affiliation></author><author><name sortKey="Schachtrupp, Alexander" sort="Schachtrupp, Alexander" uniqKey="Schachtrupp A" first="Alexander" last="Schachtrupp">Alexander Schachtrupp</name><affiliation wicri:level="3"><nlm:aff id="I3">Department of Surgery, RWTH Aachen University, Pauwelsstr. 30, 52070 Aachen, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Surgery, RWTH Aachen University, Pauwelsstr. 30, 52070 Aachen</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Aix-la-Chapelle</settlement></placeName></affiliation></author></analytic><series><title level="j">Annals of Intensive Care</title><idno type="eISSN">2110-5820</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The purpose of the present study was to quantify bacterial translocation to mesenteric lymph nodes due to different levels of intra-abdominal hypertension (IAH; 15 vs. 30 mmHg) lasting for 24 h in a porcine model.</p></sec><sec><title>Methods</title><p>We examined 18 anesthetized and intubated pigs (52.3 ± 4.7 kg) which were randomly allocated to three experimental groups (each <italic>n </italic>= 6) and studied over a period of 24 h. After preparation and establishing a steady state, the intra-abdominal pressure (IAP) was increased stepwise to 30 mmHg in six animals using a carbon dioxide (CO<sub>2</sub>) insufflator (IAP-30 group). In the second group, IAP was increased to 15 mmHg (IAP-15 group), while IAP remained unchanged in another six pigs (control group). Using a pulse contour cardiac output (PiCCO<sup>®</sup>) monitoring system, hemodynamic parameters as well as blood gases were recorded periodically. Moreover, peripheral and portal vein blood samples were taken for microbiological examinations. Lymph nodes from the ileocecal junction were sampled during an intra-vital laparotomy at the end of the observational period. After sacrificing the animals, bowel tissue samples and corresponding mesenteric lymph nodes (MLN) were extracted for histopathological and microbiological analyses.</p></sec><sec><title>Results</title><p>Cardiac output decreased in all groups. In IAP-30 animals, volumetric preload indices significantly decreased, while those of IAP-15 pigs did not differ from those of controls. Under IAH, the mean arterial pressure (MAP) in the IAP-30 group declined, while MAP in the IAP-15 group was significantly elevated (controls unchanged). PO<sub>2 </sub>and PCO<sub>2 </sub>remained unchanged. The grade of ischemic damage of the intestines (histopathologically quantified using the Park score) increased significantly with different IAH levels. Accordingly, the amount of translocated bacteria in intestinal wall specimens as well as in MLN significantly increased with the level of IAH. Lymph node cultures confirmed the relation between bacterial translocation (BT) and IAP. The most often cultivated species were <italic>Escherichia coli</italic>, Staphylococcus, Clostridium, Pasteurella, and Streptococcus. Bacteremia was detected only occasionally in all three groups (not significantly different) showing gut-derived bacteria such as Proteus, Klebsiella, and <italic>E. coli </italic>spp.</p></sec><sec><title>Conclusion</title><p>In this porcine model, a higher level of ischemic damage and more BT were observed in animals subjected to an IAP of 30 mmHg when compared to animals subjected to an IAP of 15 mmHg or controls.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Malbrain, Ml" uniqKey="Malbrain M">ML Malbrain</name></author><author><name sortKey="Cheatham, Ml" uniqKey="Cheatham M">ML Cheatham</name></author><author><name sortKey="Kirkpatrick, A" uniqKey="Kirkpatrick A">A Kirkpatrick</name></author><author><name sortKey="Sugrue, M" uniqKey="Sugrue M">M Sugrue</name></author><author><name sortKey="Parr, M" uniqKey="Parr M">M Parr</name></author><author><name sortKey="De Waele, J" uniqKey="De Waele J">J De 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Li</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>Basse-Saxe</li><li>District de Cologne</li><li>Rhénanie-du-Nord-Westphalie</li></region><settlement><li>Aix-la-Chapelle</li><li>Hanovre</li></settlement></list><tree><country name="Allemagne"><region name="Basse-Saxe"><name sortKey="Kaussen, Torsten" sort="Kaussen, Torsten" uniqKey="Kaussen T" first="Torsten" last="Kaussen">Torsten Kaussen</name></region><name sortKey="Afify, Mamdouh" sort="Afify, Mamdouh" uniqKey="Afify M" first="Mamdouh" last="Afify">Mamdouh Afify</name><name sortKey="Conze, Joachim" sort="Conze, Joachim" uniqKey="Conze J" first="Joachim" last="Conze">Joachim Conze</name><name sortKey="Herweg, Christiane" sort="Herweg, Christiane" uniqKey="Herweg C" first="Christiane" last="Herweg">Christiane Herweg</name><name sortKey="Schachtrupp, Alexander" sort="Schachtrupp, Alexander" uniqKey="Schachtrupp A" first="Alexander" last="Schachtrupp">Alexander Schachtrupp</name><name sortKey="Srinivasan, Pramod Kadaba" sort="Srinivasan, Pramod Kadaba" uniqKey="Srinivasan P" first="Pramod Kadaba" last="Srinivasan">Pramod Kadaba Srinivasan</name><name sortKey="Tolba, Rene" sort="Tolba, Rene" uniqKey="Tolba R" first="René" last="Tolba">René Tolba</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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