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RESCUE HYPOTHERMIA REDUCES ILEAL INJURY IN EXPERIMENTAL INTESTINAL ISCHAEMIA AND REPERFUSION
Author(s) -
Stefanutti G.,
Pierro A.,
Parkinson E. J.,
Smith V. V.,
Eaton S.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04125_1.x
Subject(s) - medicine , hypothermia , anesthesia , ischemia , superior mesenteric artery , ileum , surgery
Aim Moderate hypothermia is beneficial when applied throughout intestinal ischaemia‐reperfusion (IR). However, therapeutic intervention is usually possible only after ischaemia has occurred. The aim of this study was to evaluate the efficacy of hypothermia as a rescue therapy for intestinal IR. Methods Adult rats were ventilated via a tracheostomy and underwent either intestinal ischaemia‐reperfusion (60 min superior mesenteric artery occlusion, and 120 min reperfusion) or sham operation. Rats in the hypothermia groups were maintained at normothermia (36–38°C) throughout ischaemia, and were cooled at the beginning of reperfusion until reaching target temperature (moderate hypothermia: 30–32°C). Four groups (n = 8 each) were studied: 1) control normothermia; 2) IR normothermia; 3) control hypothermia; 4) IR rescue hypothermia. The degree of histological injury in terminal ileum was assessed on a semi‐quantitative scale (1 = low; 5 = high) by three blinded observers. Data (median [IQ range]) were compared by Kruskal‐Wallis test with Dunn’s post‐test. Results Intestinal IR at normothermia caused severe injury to the ileum (4.5 [4–5]) compared to both normothermic (2 [1.5–2], p < 0.01 vs. IR normothermia) and hypothermic controls (2 [1.5–2], p < 0.01 vs. IR normothermia). However, rescue hypothermia offered considerable protection from IR injury, so that intestinal architecture was partly preserved (3 [2.5–4], p = n.s. vs. control normothermia; p = n.s. vs. control hypothermia). Conclusions Moderate hypothermia reduces the extent of tissue injury following intestinal ischaemia, even when applied as a rescue therapy. It could be considered as a possible therapy in clinical conditions associated with intestinal IR.