CO2 Abdominal Insufflation Pretreatment Increases Survival After a Lipopolysaccharide-Contaminated Laparotomy

Autor:	Fuentes, Joseph M., Hanly, Eric J., Aurora, Alexander R., De Maio, Antonio, Shih, Samuel P., Marohn, Michael R., Talamini, Mark A.
Předmět:	CARBON dioxide ARTIFICIAL pneumoperitoneum IMMUNE response LAPAROSCOPIC surgery ABDOMINAL surgery HELIUM ISOFLURANE CYTOKINES SHOCK (Pathology) ANIMAL experimentation COMPARATIVE studies SURGICAL diagnosis ENDOTOXINS ESCHERICHIA coli INHALATION anesthesia INTERLEUKINS RESEARCH methodology MEDICAL cooperation RATS RESEARCH STATISTICAL sampling SURVIVAL TUMOR necrosis factors EVALUATION research INSUFFLATION LIPOPOLYSACCHARIDES INHALATION anesthetics PREVENTION
Zdroj:	Journal of Gastrointestinal Surgery; Jan2006, Vol. 10 Issue 1, p32-38, 7p
Abstrakt:	Carbon dioxide (CO2)-pneumoperitoneum is known to favorably modify the systemic immune response during laparoscopic surgery. The presented studies were designed to determine whether treating animals with CO2 abdominal insufflation before undergoing a lipopolysaccharide (LPS)-contaminated laparotomy would serve as “shock prophylaxis” and thus improve survival and attenuate cytokine production. Rats were randomized into five groups: CO2-pneumoperitoneum, helium-pneumoperitoneum, anesthesia control, laparotomy/LPS control, and LPS only control. Animals in the first four groups all received a laparotomy and a lethal dose of LPS. Immediately preceding their laparotomy, animals in the pneumoperitoneum groups received a 30-minute pretreatment of abdominal insufflation with either CO2 or helium. The anesthesia control group received a 30-minute pretreatment of isoflurane. Animal mortality was then recorded during the ensuing 72 hours. Subsequently, a similar protocol was repeated for measurements of cytokines. CO2-pneumoperitoneum increased survival at 48 hours compared with LPS control (P <.05), and decreased interleukin-6 plasma levels at 2 hours (P <.05). Abdominal insufflation with CO2 before the performance of a laparotomy contaminated with endotoxin increases survival and attenuates interleukin-6. The beneficial immune-modulating effects of CO2-pneumoperitoneum endure after abdominal insufflation. CO2-pneumoperitoneum pretreatment may improve outcomes among patients undergoing gastrointestinal surgery who are at high risk for abdominal fecal contamination. [Copyright &y& Elsevier]
Databáze:	Complementary Index
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