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find Keyword "Acute necrotizing pancreatitis Endotoxin Selective decontamination of the digestive tract" 1 results
  • PROPHYLACTIC EFFECTS OF SELECTIVE DECONTAMINATION OF THE DIGESTIVE TRACT ON GUT-ORIGINATED ENDOTOXEMIA COMPLICATED FROM ACUTE NECROTIZING PANCREATITIS

    【Abstract】Objective To investigate the preventive role of selective decontamination of the digestive tract (SDD) in gut-originated endotoxemia in acute necrotizing pancreatitis (ANP). Methods A lethal model of ANP was reproduced in Wistar rats by retrograde infusion of artificial bile into the main pancreatic duct. Normal control group (n=6), sham operation group (n=6), ANP group (n=14) and ANP+SDD (polymycin E, tobramycin and nystatin mixture) group (n=8) were randomly devided. Visceral pathologic changes, serum levels of TNFα and IL-1β, intestinal bacterial flora, plasma D(-)lactate and endotoxin contents, as well as the mortality were examined at 72h after operation in each group. Results Necrosis and inflammation of pancreas, with a remarkable elevation of serum TNFα and IL-1β and intestinal flora disturbance (with E.Coli content risen significantly) were seen in ANP rats. Simultaneously, ANP rats displayed elevated plasma concentration of D(-)lactate and endotoxin. In SDD group, enterobacteraceae and yeast were markedly depressed, while anaerobes were well preserved, with the value of B/E 〔Bifidobacterium/E.Coli, log10(CFU/CFU)〕 elevated in the ileac mucous membrane (1.73±1.23 vs -0.37±0.72 in ANP group,P<0.01) and in the caecum content (∞ vs 0.88±0.77). In addition, depressed levels of D(-)lactate 〔(3.95±1.83) mg/L vs (8.05±3.05) mg/L in ANP group,P<0.01〕, endotoxin 〔(0.227±0.084) EU/ml vs (0.423±0.155) EU/ml in ANP group, P<0.01〕 and TNFα 〔(15.41±10.32) ng/L vs (46.79±24.31) ng/L in ANP group P<0.01〕 in systemic or portal vein were observed in the SDD group. Moreover, SDD group displayed a declined 72h mortality(14.3% vs 58.8% in ANP group, P=0.005). Conclusion ANP is associated with gut barrier disorder and gut flora imbalance, which may exacerbate the process of gut-originated endotoxin translocation. By protecting gut flora and gut barrier against disorder, SDD attenuates ANPrelated endotoxemia and improves the outcome. SDD is advisable for the prophylaxis of gut-originated endotoxemia complicated from ANP.

    Release date:2016-08-28 05:30 Export PDF Favorites Scan
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