Resuscitation with hydroxyethyl starch 130/0.4 attenuates intestinal injury in a rabbit model of sepsis.
OBJECTIVE
Improvement of mucosal barrier function and reduction of bacterial translocation are important in the management of sepsis. The mechanisms that underlie the protective effects of colloids on the intestinal mucosal barrier are unclear. The study aims to investigate the effect of fluid resuscitation with hydroxyethyl starch (HES) 130/0.4 against intestinal mucosal barrier dysfunction in a rabbit model of sepsis.


MATERIALS AND METHODS
Thirty healthy rabbits were randomly and equally divided into a sham-operated control, a sepsis model, or a sepsis + HES treatment group. The sepsis model and sepsis + HES treatment groups were subjected to a modified colon ascendens stent peritonitis (CASP) procedure to induce sepsis. Four hours after the CASP procedure, fluid resuscitation was performed with 6% HES 130/0.4. Arterial and superior mesenteric vein blood samples were collected 4 and 8 h after the CASP procedure for blood gas analysis and measuring tumor necrosis factor-α, interleukin-10, and D-lactate levels. The rabbits were euthanized 8 h after CASP, and sections of the small intestine were stained to evaluate histopathological changes.


RESULTS
Respiratory rate and blood pressure were stable during the resuscitation period. Fluid resuscitation with 6% HES 130/0.4 alleviated pathological changes in the abdominal cavity, improved blood gas parameters and inflammatory mediator levels, decreased plasma D-lactate levels, and reduced intestinal mucosal injury compared with the non-treated sepsis model.


CONCLUSIONS
Fluid resuscitation with 6% HES 130/0.4 protects against intestinal mucosal barrier dysfunction in rabbits with sepsis, possibly via mechanisms associated with improving intestinal oxygen metabolism and reducing the release of inflammatory mediators.
['Lu|Wei-Hua|WH|', 'Jin|Xiao-Ju|XJ|', 'Jiang|Xiao-Gan|XG|', 'Wang|Zhen|Z|', 'Wu|Jing-Yi|JY|', 'Shen|Guang-Gui|GG|']
D000818:Animals D015415:Biomarkers D004195:Disease Models, Animal D005440:Fluid Therapy D006439:Hemodynamics D006895:Hydroxyethyl Starch Derivatives D018836:Inflammation Mediators D016753:Interleukin-10 D007410:Intestinal Diseases D007413:Intestinal Mucosa D007421:Intestine, Small D019344:Lactic Acid D008297:Male D010539:Permeability D010952:Plasma Substitutes D011817:Rabbits D012151:Resuscitation D018805:Sepsis D013997:Time Factors D014409:Tumor Necrosis Factor-alpha
resuscitation sepsis intestinal mucosal barrier HES 130/0.4 inflammatory mediators