Induced Hypothermia Preserves the Functional Enterocyte Mass in A Porcine Multiple Trauma Model
| Autor: | Ingo Witte, Sascha Flohé, Frank Hildebrand, Juliane Mohr, Philipp Mommsen, Martijn van Griensven, Roman Pfeifer, Georg A. Feichtinger, Matthias Weuster, Matthias Fröhlich, Claudia Keibl, Marc Maegele |
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| Rok vydání: | 2016 |
| Předmět: |
Necrosis
Gut barrier business.industry Enterocyte Organ dysfunction Hypothermia Liver Laceration Critical Care and Intensive Care Medicine medicine.disease chemistry.chemical_compound medicine.anatomical_structure chemistry Anesthesia Emergency Medicine Citrulline Medicine medicine.symptom business Multiple organ dysfunction syndrome |
| Zdroj: | SHOCK. :1 |
| ISSN: | 1073-2322 |
| DOI: | 10.1097/shk.0000000000000626 |
| Popis: | INTRODUCTION Multiple organ dysfunction syndrome (MODS) and the resulting multiple organ failure (MOF) following severe trauma are associated with increased morbidity and mortality. Due to intestinal mucosal lesions and gut barrier disorders, the intestine contributes decisively to how post-traumatic MOF develops. As mild therapeutic hypothermia has been found to have protective effects on post-traumatic organ injuries, we analysed its effects on the intestine. METHODS In a porcine model, Forty pigs were assigned to four groups: sham or trauma groups each with two sub-groups receiving either hypothermia or normothermia. The trauma was a combined trauma of blunt chest trauma, liver laceration and haemorrhagic shock. Functional enterocyte mass and enterocyte necrosis were evaluated by measuring plasma citrulline and iFABP. Mucosal lesions were assessed using a semi-quantitative histological scoring system. RESULTS In normothermic trauma animals, citrulline decreased significantly compared to both sham groups and to the hypothermic trauma group. However, citrulline levels did not differ significantly between the hypothermic trauma group and the hypothermic sham group. Although histological analysis demonstrated subepithelial lifting and mucosal oedema in the ileal mucosa of all trauma animals, the semi-quantitative score of the group treated with hypothermia was comparable to that of the hypothermic sham group. However, the score was significantly elevated in normothermic trauma animals in comparison to sham and hypothermic trauma animals. CONCLUSION Induced hypothermia preserves the functional enterocyte mass after severe trauma. Therefore induced hypothermia might represent a therapeutic strategy to avoid posttraumatic organ dysfunction, although further studies regarding the safety and long-term effects are required. LEVEL OF EVIDENCE Level III; therapeutic study. |
| Databáze: | OpenAIRE |
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