Adverse effect of splenectomy in experimental XXXX .

@entity1 @entity298 @entity505 @entity3398 @entity35 @entity393 @entity413
@entity1 undergoing splenectomy have increased operative morbidity and mortality, especially when associated with gastrointestinal surgery or injury. This present study was designed to assess the effect of splenectomy on mortality in a polymicrobial @entity298 model and evaluate therapy with antibiotic ( @entity3398 ) or immunomodulation (glucan). @entity1 stool-barium (0.15 cc) was placed in the peritoneum of @entity35 at the time of splenectomy or sham surgery. Splenectomy animals were then treated with 5% @entity413 , @entity3398 (60 mg im q 6 hr), glucan (7.5 mg ip prior to surgery), or @entity3398 plus glucan. Splenectomy resulted in decreased survival (5% vs 30%, P less than 0.05). Treatment with @entity3398 (90%) or glucan (47%) significantly improved survival. Combined glucan- @entity3398 therapy had no improvement over @entity3398 alone. Peritoneal and blood cultures were performed 12 hr postoperatively. There were no significant differences in growth of bacteria between sham and splenectomy animals. @entity3398 treatment resulted in lower growth of bacteria from both blood and peritoneum (P less than 0.05). Glucan treatment caused a significant @entity393 (P less than 0.05). Intravascular colloidal @entity505 clearance and leucocyte counts were performed at 12 hr postoperatively. Presence of @entity298 significantly enhanced intravascular clearance, while splenectomy had no effect. Addition of glucan or @entity3398 therapy to splenectomy animals did not enhance intravascular clearance. Leucocyte counts were significantly lower (P less than 0.05) when splenectomy was added to @entity298 animals. Glucan and @entity3398 therapy did not increase leucocyte counts. Based on these studies we conclude that (1) splenectomy increases mortality in @entity298 , (2) antibiotic and immunomodulator afford some protection, and (3) exact mechanism of protection remains unclear.
