The effects of intravenous epidermal growth factor on bacterial translocation and central venous catheter infection in the rat total parenteral nutrition model
| Autor: | David A. Lloyd, H. K. F. van Saene, H. F. McAndrew, Risto Rintala |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Catheterization
Central Venous medicine.medical_specialty medicine.medical_treatment Lumen (anatomy) Gastroenterology Sepsis 03 medical and health sciences 0302 clinical medicine Epidermal growth factor Internal medicine Escherichia coli medicine Animals Mesenteric lymph nodes Intestinal Mucosa Rats Wistar Infusions Intravenous Saline 030304 developmental biology 0303 health sciences Epidermal Growth Factor business.industry General Medicine medicine.disease Rats 3. Good health Catheter Parenteral nutrition medicine.anatomical_structure Bacterial Translocation Pediatrics Perinatology and Child Health Immunology Parenteral Nutrition Total 030211 gastroenterology & hepatology Surgery business Enterococcus Central venous catheter |
| Zdroj: | Pediatric Surgery International. 16:169-173 |
| ISSN: | 1437-9813 0179-0358 |
| DOI: | 10.1007/s003830050715 |
| Popis: | Sepsis is a major complication of total parenteral nutrition (TPN) in children. Gut mucosal atrophy (GMA) and bacterial translocation (BT) occur in patients receiving TPN, and the translocated enteric organisms may cause central venous catheter (CVC) infection. Epidermal growth factor (EGF) has a trophic effect on the gut mucosa and may reduce BT, thereby reducing catheter infection. Using a rat TPN model, the relationship between GMA, BT, and catheter sepsis was examined and the effect on these of intravenous EGF was studied. There were four experimental groups. Group 1 had no CVC, Groups 2, 3, and 4 had a continuous central venous infusion as follows: group 2, saline; group 3, TPN; group 4, TPN with EGF. Groups 1 and 2 had free access to chow, groups 3 and 4 had no enteral feeds. After killing at 1 week, blood, tissue, and catheter specimens were cultured and mucosal morphology analysed. BT was defined as the presence of the same organism in cultures from the gut lumen and mesenteric lymph nodes (MLN). TPN only (group 3) resulted in GMA and BT, and 5 of 12 animals with BT had the same gut bacteria in blood and/or catheter cultures. The addition of EGF to the TPN significantly reduced GMA, BT to the MLN, and blood and/or catheter infections (P =< 0.05). In animals carrying enterococci, there was a significant reduction in translocation of enterococci (group 3: 8/14; group 4: 0/11; P < 0.05) and catheter infection by enterococci was prevented (group 3: 3/14; group 4: 0/11). EGF thus reduced GMA, BT, and blood and/or catheter infection when given IV to rats receiving TPN. Enterococcal translocation and subsequent blood and/or catheter infection was completely prevented, suggesting a selective effect of EGF. |
| Databáze: | OpenAIRE |
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