Postburn gastrointestinal vasoconstriction increases bacterial and endotoxin translocation.
Postburn gastrointestinal vasoconstriction increases bacterial and endotoxin translocation.
复制标题
烧伤后胃肠道血管收缩会增加细菌和内毒素的易位。
DOI：
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发表时间：
1993
影响因子：
3.3
通讯作者：
D. Herndon
中科院分区：
文献类型：
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作者：
R. Tokyay;S. T. Zeigler;D. Traber;J. Stothert;H. Loick;J. Heggers;D. Herndon
内脏缺血与肠道细菌移位和内毒素吸收增加有关。为了研究严重烧伤对内脏循环的影响，将小型猪随机分为40%火焰烧伤和帕克兰复苏组或假烧伤和维持液组。测定48 h的总血流量和分次血流量、O2输送和消耗、肠粘膜pH值和上级肠系膜静脉内毒素水平，然后收获腹部器官进行细菌学培养和组织病理学分析。肠系膜总血流量和空肠，盲肠和结肠的粘膜-粘膜下层的分级血流量减少2和4小时烧伤后。虽然肠系膜O2消耗量不变，肠系膜O2输送和肠粘膜pH值下降，在烧伤后早期。同时，内毒素水平在上级肠系膜静脉显着升高，在第一个8小时烧伤后。全身组织标本细菌学培养显示烧伤组细菌移位增加。严重烧伤后，会出现短暂的选择性内脏血管收缩，这与肠粘膜酸中毒以及细菌移位和肠道内毒素吸收发生率增加有关。
Splanchnic ischemia has been associated with bacterial translocation and increased endotoxin absorption from the gut. To study the effects of major burn on splanchnic circulation, minipigs were randomized to receive 40% flame burn and Parkland resuscitation or sham burn and maintenance fluids. Total and fractionated blood flow, O2 delivery and consumption, mucosal pH of the intestine, and endotoxin levels in the superior mesenteric vein were measured for 48 h, and then abdominal organs were harvested for bacteriological culture and histopathological analysis. Total mesenteric blood flow and fractionated blood flow to the mucosa-submucosa of the jejunum, cecum, and colon decreased 2 and 4 h postburn. Although mesenteric O2 consumption was unchanged, mesenteric O2 delivery and intestinal mucosal pH were decreased during the early postburn period. Concomitantly, endotoxin levels in the superior mesenteric vein were significantly elevated during the first 8 h postburn. The bacteriological cultures of the systemic tissue samples showed increased bacterial translocation in the burn group. After major burns, there is a transient selective splanchnic vasoconstriction, which is associated with intestinal mucosal acidosis and increased incidence of bacterial translocation and endotoxin absorption from the gut.