Intramucosal pH and intestinal mucosal damage in ischemia-reperfusion injury

Abstract

Small bowel transplantation (SBT) has become an increasingly promising treatment for short bowel syndrome. The evaluation of graft viability after SBT, however, has not been established, except by mucosal biopsy. We monitored intestinal mucosal acidity in order to detect small intestinal ischemia-reperfusion injury. Mongrel dogs were used in this study. After laparotomy, the small bowel was isolated with a vascular pedicle. A tonometer to measure intramucosal p H (pHi) was then positioned in the terminal ileum. The superior mesenteric artery was occluded with or without concomitant superior mesenteric vein occlusion for 60 or 120 min. The value of pHi was determined from laparotomy (baseline) to 12 h after reperfusion. Whole-thickness specimens of the ileum were taken before ischemia, just before reperfusion, and 1 h afterward. Mucosal injury was graded histopathologically. pHi decreased from baseline in relation to the degree of histopathological mucosal injury. There was a significant correlation between histological findings and the change in pHi. We conclude that monitoring intestinal mucosal acidity is a reliable way of determining graft viability after SBT.

Bradykinin B2 Receptor Antagonist FR173657 Ameliorates Small Bowel Ischemia?Reperfusion Injury in Dogs

“…50, No. 1 (January 2005) between histological findings and the change in pH i and that monitoring intestinal mucosal acidity was a reliable way of determining graft viability after I/R (15). Furthermore, the mesenteric blood flow rate of the small bowel is known to decrease progressively after reperfusion of the autograft and the subsequent increase in the mesenteric vascular resistance (21).…”

“…Intramucosal pH (pH i ) was measured prior to ischemia, during ischemia, and at 1, 3, 6, and 12 hr after reperfusion. This method has been described previously (15). In brief, a tonometer (Trip; Tonometrics, Helsinki, Finland) was inserted into the small bowel lumen through a small incision in the bowel wall and secured with a purse-string suture.…”

Regional Blood Flow Distribution and Oxygen Metabolism During Mesenteric Ischemia and Congestion

“…Several experimental and clinical studies have extensively examined the hemodynamic and metabolic effects of superior mesenteric artery occlusion [4][5][6][7]. On the other hand, the cardiocirculatory derangement and the tissue damage induced by intestinal outflow obstruction have not been investigated systematically, despite their clear clinical importance. For these reasons, we have decided to assess the initial impact of venous mesenteric occlusion on intestinal mucosal and serosal blood flow distribution, and to correlate these findings with other systemic and regional perfusion markers.…”

The Effect of Nicorandil on Small Intestinal Ischemia–Reperfusion Injury in a Canine Model

“…Pre before ischemia, JBIR just before intestinal reperfusion, re-1 h after 1 h of reperfusion, re-3 h after 3 h of reperfusion, re-6 h after 6 h of reperfusion, re-12 h after 12 h of reperfusion perfusion [18]. We previously reported that there was a significant correlation between histological findings and the change in pHi and that monitoring intestinal mucosal acidity was a reliable way of determining graft viability after intestinal IR [13]. In addition, histopathological grading of the small intestine has been used to determine intestinal IR injury as well as the SMA blood flow rates in animal model studies of intestinal IR [4].…”

“…This method has been described previously [13]. In brief, a tonometer (Trip; Tonometrics, Helsinki, Finland) was inserted into the small intestinal lumen through the stoma.…”