Direct peritoneal resuscitation augments ileal blood flow in necrotizing enterocolitis via a novel mechanism

Autor: Alexandra C. Maki, Jessica A. Shepherd, Paul J. Matheson, Cynthia D. Downard, Richard N. Garrison
Rok vydání: 2012
Předmět:
medicine.medical_specialty
Pathology
Resuscitation
Endothelin A Receptor Antagonists
Urinary Bladder
Peptides
Cyclic
Gastroenterology
Microcirculation
Nitric oxide
Rats
Sprague-Dawley
Mefenamic Acid
Random Allocation
chemistry.chemical_compound
Piperidines
Peritoneum
Enterocolitis
Necrotizing
Ileum
Dialysis Solutions
Internal medicine
medicine
Animals
Cyclooxygenase Inhibitors
Infusions
Parenteral
business.industry
Osmolar Concentration
General Medicine
Blood flow
Laser Doppler velocimetry
medicine.disease
digestive system diseases
Endothelin B Receptor Antagonists
Rats
Solutions
NG-Nitroarginine Methyl Ester
medicine.anatomical_structure
Animals
Newborn
chemistry
Models
Animal
Pediatrics
Perinatology and Child Health
Necrotizing enterocolitis
Surgery
Nitric Oxide Synthase
Endothelin receptor
business
Oligopeptides
Zdroj: Journal of Pediatric Surgery. 47:1128-1134
ISSN: 0022-3468
DOI: 10.1016/j.jpedsurg.2012.03.017
Popis: Endothelin-1, prostaglandins (PGs), and nitric oxide (NO) have been implicated in the intestinal microvascular dysfunction of necrotizing enterocolitis (NEC). We hypothesized that direct peritoneal resuscitation (DPR) dilates the intestinal microvasculature and improves blood flow independent of these mechanisms.Rat pups were assigned by litter to experimental NEC or CONTROL groups. Laser Doppler flowmetry evaluation of intestinal microvascular blood flow was studied at baseline, with mediator blockade (endothelin-A receptor, endothelin-B receptor, PG synthesis, or NO synthase) and with DPR. Repeated-measures analysis of variance test was applied with Tukey-Kramer honestly significant difference test (P.05).At baseline, NEC animals demonstrated significantly decreased ileal blood flow as compared with CONTROLs (P.05). Endothelin-A receptor and PG inhibition increased flow in the intestinal microvasculature, but this was significantly augmented by the addition of DPR (P.05). Blockade of NO synthase decreased intestinal blood flow, which was overcome with addition of DPR (P.05).Ileal blood flow was significantly reduced in NEC animals as compared with CONTROLs. The addition of DPR to the peritoneum increased ileal blood flow significantly in all groups in spite of blockade of these known vasoactive mechanisms. Direct peritoneal resuscitation may be a novel strategy to improve intestinal blood flow in NEC.
Databáze: OpenAIRE
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