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Effects of thoracic epidural anaesthesia on intestinal microvascular perfusion in a rodent model of normotensive endotoxaemia

Effects of thoracic epidural anaesthesia on intestinal microvascular perfusion in a rodent model of normotensive endotoxaemia

Authors :
Adolphs, Jorn
Schmidt, Diego K.
Korsukewitz, Ines
Kamin, Britta
Habazettl, Helmut
Schafer, Michael
Welte, Martin
Source :
Intensive Care Medicine. Nov, 2004, Vol. 30 Issue 11, p2094, 8 p.
Publication Year :
2004

Abstract

Byline: Jorn Adolphs (1), Diego K. Schmidt (1), Ines Korsukewitz (1), Britta Kamin (1), Helmut Habazettl (2,3), Michael Schafer (1), Martin Welte (4) Keywords: Animal model; Sympathetic blockade; Sepsis; Intravital microscopy; Blood flow; Mucosa Abstract: Objective To investigate whether sympathetic blockade by means of thoracic epidural anaesthesia (TEA) increases intestinal perfusion during normotensive endotoxaemia. Design A prospective, randomised and controlled animal study. Setting Animal laboratory in a university hospital. Subjects Sprague-Dawley male rats. Interventions The rats were anaesthetised with urethane and ketamine, mechanically ventilated and haemodynamically monitored. Lidocaine or saline were infused continuously via thoracic epidural catheters followed by a continuous intravenous infusion of Escherichia coli lipopolysaccharide (1.5 mg/kg per h). Densities of perfused and non-perfused capillaries (i.e., with and without erythrocyte perfusion, respectively) as well as erythrocyte velocity in both the mucosa and the muscularis of the terminal ileum were determined using intravital microscopy. Measurements and results Measurements were performed at baseline, after 30 min of epidural infusion as well as after 60 and 120 min of lipopolysaccharide infusion. In animals receiving TEA, mean arterial pressure and heart rate were significantly reduced throughout the experiment. In the muscularis the endotoxaemia-induced increase in non-perfused capillaries was absent with epidural lidocaine (0 [0/0] versus 39 [36/137] cm.sup.-1, median [25.sup.th/75.sup.th percentile]), whereas in the mucosa perfused capillary density declined to a greater extent than in controls (-47 [-53/-23]%) versus -19 [-34/+10]%, p Conclusions Microvascular perfusion data during endotoxaemia show a redistribution of blood flow towards the mucosa. TEA seems to impede this redistribution resulting in improved muscularis and worsened mucosal microvascular perfusion. Author Affiliation: (1) Department of Anaesthesiology and Critical Care Medicine, Campus Benjamin Franklin, Charite--Universitatsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Germany (2) Department of Physiology, Campus Benjamin Franklin, Charite--Universitatsmedizin Berlin, Arnimallee 22, 14095, Berlin, Germany (3) Department of Anaesthesiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany (4) Department of Anaesthesiology and Intensive Care Medicine, Klinikum Darmstadt, Grafenstrasse 9, 64283, Darmstadt, Germany Article History: Registration Date: 05/08/2004 Received Date: 04/03/2004 Accepted Date: 30/07/2004 Online Date: 26/08/2004

Details

Language :
English
ISSN :
03424642
Volume :
30
Issue :
11
Database :
Gale General OneFile
Journal :
Intensive Care Medicine
Publication Type :
Academic Journal
Accession number :
edsgcl.179869126