The gut as source of sepsis after hemorrhagic shock

Sori, Alan J.; Rush, Benjamin F.; Lysz, Thomas W.; Smith, Sharon; Machiedo, George W.

doi:10.1016/s0002-9610(88)80691-3

Cited by 170 publications

(33 citation statements)

References 24 publications

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“…Disruption of the indigenous intestinal flora [5, 6], damage to the intestinal mucosa [7, 8]and impaired host defences [9]also occur in acute pancreatitis, with incidences and characteristics similar to those found and studied in greater detail in other serious diseases. This phenomenon has recently been corroborated by experimental studies with induced pancreatitis [10, 11].…”

Section: Introductionmentioning

confidence: 99%

Lactobacillus plantarum Reduces Infection of Pancreatic Necrosis in Experimental Acute Pancreatitis

Mangiante¹,

Colucci²,

Canepari³

et al. 2001

Dig Surg

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Background: Infection is the commonest cause of death in acute pancreatitis. Early reduction of commensal flora (particularly Lactobacillus species) and, at the same time, overgrowth of Enterobacteriaceae, especially Escherichia coli, have recently been described during acute pancreatitis. Lactobacillus plantarum has been shown to be effective in reducing the egress of endotoxin and microbial translocation in several experimental models such as chemically induced hepatitis and ulcerative colitis. Aim: The aim of the study was to determine whether L. plantarum 299v (Lp 299v) is capable of effectively reducing microbial translocation in experimental pancreatitis. Methods: Acute pancreatitis was induced by isolation and ligation of the biliopancreatic duct in Lewis rats weighing 250–350 g. The animals were divided into 3 groups: group A, sham operation; group B, induction of pancreatitis and no further treatment, and group C, induction of pancreatitis + daily administration by gavage of a 5-ml/day suspension of Lp 299v at 0.5–1.0 × 10⁹ bacteria/ml for 8 days, 4 days before and 4 days after induction of pancreatitis. All animals were sacrificed after 96 h. Histological studies and microbiological analyses were performed. Results: At sacrifice, 40/55 animals showed signs of severe pancreatitis. Since acute pancreatitis was the specific disease investigated, only these animals were subjected to further study. In group B, we found pathogenic micro-organisms in the mesenteric lymph nodes in 14/20 animals and in the pancreatic tissue in 10/20. The bacterial flora consisted predominantly of E. coli, Enterococcus faecalis, Pseudomonas and Proteus species. In contrast, when the animals were kept under an ’umbrella’ of Lp 299v, growth of E. faecalis or E. coli were detected only in 4/20 mesenteric lymph node cultures and in 3/20 pancreatic tissue cultures. Conclusions:Lp 299v is effective in reducing microbial translocation in experimental pancreatitis. Treatment with probiotic bacteria seems to be a promising alternative to antibiotic therapy.

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Section: Introductionmentioning

confidence: 99%

Lactobacillus plantarum Reduces Infection of Pancreatic Necrosis in Experimental Acute Pancreatitis

Mangiante¹,

Colucci²,

Canepari³

et al. 2001

Dig Surg

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“…

bacteria and endotoxin which may contribute to inAlthough intestinal mucosal immune dysfunction oc-creased susceptibility to infections and sepsis after curs after trauma and hemorrhage and appears to con-trauma and hemorrhagic shock [1][2][3]. Under physiotribute to infectious complications, the mechanism is not logic conditions, the intestinal mucosal barrier typiknown.

…”

mentioning

confidence: 99%

Mechanism of Intestinal Mucosal Immune Dysfunction Following Trauma–Hemorrhage: Increased Apoptosis Associated with Elevated Fas Expression in Peyer's Patches

Ayala

Monfils

et al. 1997

Journal of Surgical Research

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“…Berg and Garlington [1] initially reported BT in laboratory animals. Several studies have reported BT under conditions such as irradiation [2,3], trauma [4,5], burn [6][7][8], total parenteral nutrition [9][10][11], administration of lipopoly-saccharide (LPS) [12,13] and hemorrhagic shock [14][15][16]. When BT develops, microorganisms may pass through the intestinal wall, invade the lymphatic system and reach various organs throughout the body via the blood.…”

Section: Introductionmentioning

confidence: 99%

New Method for the Detection of Bacterial Translocation Using Intestinal Permeability with Polyethylene Glycol 4000

Ameno¹,

Tani²,

Hanasawa³

et al. 2000

Eur Surg Res

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Background: Currently, there is no method of accurately diagnosing bacterial translocation (BT) in humans. BT may be related to changes in intestinal permeability. In this study, we examined the correlation between intestinal permeability using polyethylene glycol (PEG) 4000 and BT. Materials and Methods: Under general anesthesia, laparotomy was done in rats, and PEG4000 was administered to the small intestine. We prepared models of invasive stimulation in which lipopolysaccharide (LPS) was intravenously administered, and a hemorrhagic shock model in which blood pressure was decreased to 30 mm Hg. Blood PEG4000 levels were measured. We also measured blood PEG levels in a model in which oxygen was administered to treat hemorrhagic shock. In all models, the presence or absence of BT development was evaluated. Results: In groups given LPS, mean blood PEG levels were significant higher than in the group treated with saline solution. In the hemorrhagic shock group, the mean PEG level was increased but was slightly inhibited by oxygen administration. In the LPS and hemorrhagic shock groups, the incidene of BT was significantly greater than in the control group. In the hemorrhagic shock group, the incidence of BT was 0% after oxygen administration. There was a correlation between the incidence of BT and changes in the intestinal permeability of PEG4000 (R² = 0.824). Conclusions: LPS stimulation enhanced intestinal permeability in a dose-dependent manner. An increase in intestinal permeability was correlated with the incidence of BT. Blood PEG4000 levels correlated positively with the grade of invasion and the incidence of BT.

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The gut as source of sepsis after hemorrhagic shock

Cited by 170 publications

References 24 publications

Lactobacillus plantarum Reduces Infection of Pancreatic Necrosis in Experimental Acute Pancreatitis

Lactobacillus plantarum Reduces Infection of Pancreatic Necrosis in Experimental Acute Pancreatitis

Mechanism of Intestinal Mucosal Immune Dysfunction Following Trauma–Hemorrhage: Increased Apoptosis Associated with Elevated Fas Expression in Peyer's Patches

New Method for the Detection of Bacterial Translocation Using Intestinal Permeability with Polyethylene Glycol 4000

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