Effect of carbon dioxide pneumoperitoneum on bacteremia and severity of peritonitis in an experimental model

İpek, Turgut; Paksoy, Melih; Çolak, Tahsin; Polat, Erdal; Uygun, Nesrin

doi:10.1007/s004649900697

Cited by 32 publications

(29 citation statements)

References 5 publications

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“…It is likely, therefore, that the elevated intra-abdominal pressure used to maintain pneumoperitoneum may increase the plasma endotoxin level. In contrast, some experimental peritonitis studies have reported that positive pressure insufflation of the peritoneal cavity did not increase bacterial translocation from the peritoneal cavity into the bloodstream [15][16][17]. However, changes in plasma endotoxin levels immediately after the operative procedure were not measured in those studies.…”

Section: Discussionmentioning

confidence: 40%

Effect of CO<sub>2</sub> Pneumoperitoneum on the Systemic and Peritoneal Cytokine Response in a LPS-Induced Sepsis Model

et al. 2001

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We studied the effect of carbon dioxide (CO₂) pneumoperitoneum on the systemic and peritoneal cytokine response in a rat model of intraperitoneal sepsis. After intraperitoneal injection of bacterial lipopolysaccharide (LPS, 10 mg/kg), rats were divided into 3 groups (n = 49 in each group): control (abdominal puncture); CO₂ pneumoperitoneum, and laparotomy. Blood and peritoneal lavage fluid (PLF) were sampled at 0, 1, 2, 3, 4, 6, and 8 h after LPS challenge. Blood cell counts, plasma endotoxin level, and the levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) in the plasma and PLF were measured. Blood cell counts did not differ between the 3 groups. Plasma endotoxin levels in the pneumoperitoneum group were significantly increased immediately after the procedure (p < 0.05). Although peak plasma TNF-α levels in the pneumoperitoneum group were seen immediately after the procedure, other changes in plasma cytokine levels did not differ significantly between the 3 groups. PLF TNF-α and IL-1β levels in the pneumoperitoneum group were significantly lower than levels in the control and laparotomy groups soon after the procedure (p < 0.05). PLF IL-6 levels in the pneumoperitoneum group tended to be lower than those in the laparotomy group. In conclusion, CO₂ pneumoperitoneum might induce different responses between systemic and peritoneal cytokines soon after the procedure in a rat model of intraperitoneal sepsis.

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Section: Discussionmentioning

confidence: 40%

Effect of CO<sub>2</sub> Pneumoperitoneum on the Systemic and Peritoneal Cytokine Response in a LPS-Induced Sepsis Model

et al. 2001

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“…Study in rats showed that pneumoperitoneum causes intestinal ischemia with oxygen free radical production and bacterial translocation, related to mechanical pressure of CO 2 17 . Other studies focused on whether a pneumoperitoneum amplifies the extent and severity of peritonitis or of bacteremia in various animal models 18,19,20,21 . Findings from these investigations are controversial.…”

Section: Discussionmentioning

confidence: 99%

“…It has not been clear whether a laparoscopic approach worsens the septic state or whether minimally invasive surgery is beneficial in these critically ill patients. Experimental model -Several animal models of peritoneal sepsis have been described varying in many respects, including the specific animal utilized and the method of sepsis 20,23,24,25 . The model of creating sepsis used in this study was adapted from the work of Hanly et al 26 .…”

Section: Discussionmentioning

confidence: 99%

Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model

et al. 2006

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Purpose: Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO 2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. Methods: Wistar rats were randomly assigned to five groups: control (anesthesia only), laparotomy, CO 2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFα, IL-1β, IL-6 were determined in intraperitoneal fluid (by ELISA). Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. Results: Peritoneal TNFα, IL-1β and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (p<0.05). TNFα, IL-1β and IL-6 expression was lower in the laparoscopic than in laparotomic sepsis (p<0.05). Rats from laparoscopic cecum ligation and puncture group developed significant hypercarbic acidosis in blood and subperitoneal fluid when compared to open procedure group. Total white blood cells and lymphocytes were significantly lower in laparoscopic cecum ligation and puncture rats than in the laparotomic (p<0.01). Nevertheless, the laparotomic cecum ligation rats had a significant increase in blood neutrophils and eosinophils when compared with controls (p<0.05). Conclusions: This study demonstrates that the CO 2 pneumoperitoneum reduced the inflammatory response in an animal model of peritonitis with respect to intraperitoneal cytokines, white blood cell count and clinical correlates of sepsis. The pneumoperitoneum produced hypercarbic acidosis in septic animals. Key words: Pneumoperitoneum. Carbon Dioxide. Sepsis. Acidosis. Leucocytes. RESUMO Objetivo:A cirurgia laparoscópica está associada com trauma reduzido e baixa resposta na fase aguda do trauma, quando comparada com a cirurgia aberta. As citocinas e o balanço ácido-base são fatores importantes da resposta biológica ao trauma cirúrgico-anestésico. O objetivo deste estudo foi determinar se o pneumoperitôneo com CO 2 altera a expressão das citocinas, a gasometria e a contagem diferencial de leucócitos em ratos com sepse abdominal. Métodos: Ratos Wistar foram aleatoriamente distribuídos em 5 grupos: controle (somente anestesia), laparotomia, pneumoperitôneo com CO 2 , ligadura e punção do ceco por laparotomia, ligadura e punção do ceco por laparoscopia. Após 30 minutos dos procedimentos, sangue arterial foi colhido para leucometria diferencial em hemocitômetro. TNFα, IL-1β e IL-6 foram dosadas no líquido intraperitoneal (por ELISA). Os parâmetros gasosos foram medidos no sangue arterial e nos exsudatos intraperitoneal e subperitoneal. Resultados: Os valores de TNFα, IL-1β e IL-6 foram significantemente menores nos ratos submetidos ao pneumoperitôneo do que em...

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“…However, the use of pneumoperitoneum in infections remains a controversial issue. Sare et al 9 and Ipek et al 10 demonstrated in an experimental study that pneumoperitoneum induced greater bacteremia than the laparoscopic technique 9,10 . In contrast, Benoit et al 2 who conducted a prospective analysis of patients operated using the videolaparoscopic approach for acute appendicitis, with and without peritonitis, observed no positive blood cultures after performing the procedure, nor incidence of septic complications, and reported no increase in morbidity 2 .…”

Section: Discussionmentioning

confidence: 99%

“…Colonies UFC/ml 4-Anti-sepsis using polyvinylpyrrolidone iodine; 5-A small incision was made into the abdominal wall to introduce an 18 abocath-type catheter which was affixed using polyglycolic acid 3-0 thread above the umbilical scar; 6-Inoculation with 2.0ml of a solution containing Escherichia coli ATCC at a concentration of 10 10 UFC and 1ml of barium sulfate; …”

Section: Animalmentioning

confidence: 99%

Analysis of the bactericidal effect of ozone pneumoperitoneum

Silva¹,

Garotti²,

Silva³

et al. 2009

Acta Cir. Bras.

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Purpose:To assess the bactericidal action of ozone pneumoperitonium, and to compare the results with CO2. Methods: It was used 36 Wistar rats. The animals, under anesthesia, were inoculated with 2ml of E. coli ATCC at a concentration of 10 10 UFC, and 1ml of BaSO4, into the peritoneal cavity. They were divided into three groups: Group 1, CO2 pneumoperitoneum was performed for 15 minutes; Group 2, ozone pneumoperitoneum was performed for 5 minutes at a concentration of 42µg/ml, and Group 3, ozone pneumoperitoneum was performed for 5 minutes at a concentration of 62µg/ml. Six animals from each group were sacrificed after the experiment, and the remaining 6 observed for 24 hours. Material was collected from the cavity of all animals for microbiological study. Results: Ozone presented a greater bactericidal effect than CO2 in those animals sacrificed immediately after pneumoperitoneum. In the animals studied 24 hours after pneumoperitoneum evidenced no difference in bactericidal effect between the two gases. Moreover, no difference in mortality was observed. Conclusion: Ozone has a more potent bactericidal effect than carbon dioxide gas, although this did not influence survival of the animals. Key words: Peritonitis. Ozone. Laparoscopy. Peritoneum. Rats. RESUMOObjetivo: Avaliar a ação bactericida do pneumoperitônio de ozônio comparando-o à ação do CO2. Métodos: Foram utilizados 36 ratos Wistar. Após anestesia e inoculação de 2ml de E. coli ATCC na concentração de 10 10 UFC e 1ml de BaSO4 na cavidade peritoneal, os animais foram divididos em três grupos: Grupo 1, realização de pneumoperitônio de CO2 por 15 minutos; Grupo 2, realização de pneumoperitônio de ozônio durante 5 minutos na concentração de 42µg/ml, e Grupo 3, realização de pneumoperitônio de ozônio durante 5 minutos na concentração de 62µg/ml. Seis animais de cada grupo foram sacrificados após experimento e os outros seis foram observados por 24 horas. Em todos os animais colheu-se material da cavidade para estudo microbiológico. Resultados: O ozônio teve maior efeito bactericida em comparação ao CO2 nos animais sacrificados logo após pneumoperitônio. Nos animais estudados após 24 horas não houve diferença do efeito bactericida entre os gases. Também não se observou alteração da mortalidade. Conclusão: O ozônio tem efeito bactericida mais potente que o gás carbônico, embora não tenha influenciado a sobrevida dos animais. Descritores: Peritonite. Ozônio. Laparoscopia. Peritônio. Ratos.

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Effect of carbon dioxide pneumoperitoneum on bacteremia and severity of peritonitis in an experimental model

Abstract: In rats, pneumoperitoneum can't cause a more severe peritonitis but it does induce an increase in the rate of bacteremia within the early 6-h period of peritonitis.

Cited by 32 publications

References 5 publications

Effect of CO<sub>2</sub> Pneumoperitoneum on the Systemic and Peritoneal Cytokine Response in a LPS-Induced Sepsis Model

Effect of CO<sub>2</sub> Pneumoperitoneum on the Systemic and Peritoneal Cytokine Response in a LPS-Induced Sepsis Model

Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model

Analysis of the bactericidal effect of ozone pneumoperitoneum

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