Chinese medical sciences journal = Chung-kuo i hsueh k'o hsueh tsa chih · 2001
Gut barrier function damage following multiple firearm injuries in a porcine model.
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Li Z, Yang X, Lu L, Yu Y, Yao Y
Аннотация
OBJECTIVE: To study the characteristics and pathogenesis of gut barrier damage following multiple firearm injuries in a porcine model.
METHODS: Twenty-four small pigs were divided into 4 groups: control group (n = 6, group C), group H (n = 6, gunshot-induced tangential fracture of parietal bone), group L (n = 6, gunshot-induced comminuted fracture of bilateral femora) and group M (n = 6, combined group H + L). Gastric intramucosal pH (pHi), plasma endotoxin levels in portal vein, and plasma D-lactate levels were measured and blood samples were cultured at different intervals after trauma. The animals were sacrificed at 72 h following trauma and intestinal tissues were harvested for pathological examination and diamine oxidase (DAO) activity measurement.
RESULTS: In group M at 72 h, pHi was significantly lower than that of group H and L ( P < 0.01), and plasma endotoxin level was significantly higher than that of group H (P < 0.01) and group L (P < 0.05). Simultaneously, in group M, D-lactate level was markedly higher than that of group H ( P < 0.01), and incidence of positive blood culture was much higher than that of group H and L ( P < 0.05). Necrosis and exfoliation were revealed at ileum villus top in all trauma groups, especially in group M, in which ileum DAO activity declined most significantly as well.
CONCLUSION: Multiple trauma is prone to cause gastrointestinal ischemia even without hemorrhagic shock. The damage of gut barrier in multiple trauma appears to be more severe than that in one-site trauma, thereby promoting gut-derived endotoxemia and bacterial translocation and contributing to the development of endogenous infection.
METHODS: Twenty-four small pigs were divided into 4 groups: control group (n = 6, group C), group H (n = 6, gunshot-induced tangential fracture of parietal bone), group L (n = 6, gunshot-induced comminuted fracture of bilateral femora) and group M (n = 6, combined group H + L). Gastric intramucosal pH (pHi), plasma endotoxin levels in portal vein, and plasma D-lactate levels were measured and blood samples were cultured at different intervals after trauma. The animals were sacrificed at 72 h following trauma and intestinal tissues were harvested for pathological examination and diamine oxidase (DAO) activity measurement.
RESULTS: In group M at 72 h, pHi was significantly lower than that of group H and L ( P < 0.01), and plasma endotoxin level was significantly higher than that of group H (P < 0.01) and group L (P < 0.05). Simultaneously, in group M, D-lactate level was markedly higher than that of group H ( P < 0.01), and incidence of positive blood culture was much higher than that of group H and L ( P < 0.05). Necrosis and exfoliation were revealed at ileum villus top in all trauma groups, especially in group M, in which ileum DAO activity declined most significantly as well.
CONCLUSION: Multiple trauma is prone to cause gastrointestinal ischemia even without hemorrhagic shock. The damage of gut barrier in multiple trauma appears to be more severe than that in one-site trauma, thereby promoting gut-derived endotoxemia and bacterial translocation and contributing to the development of endogenous infection.