Hemorrhagic shock influence on colonic anastomoses in rats: evaluation of rupture by liquid distension resistance test

Pereira, Yara Ematne Amaral; Fagundes, João José; Morandini, Rosana Celestina; Ayrizono, Maria de Lourdes Setsuko; Nascimento, Ricardo Bolzam do; Leal, Raquel Franco; Góes, Juvenal Ricardo Navarro; Mantovani, Mário; Coy, Cláudio Saddy Rodrigues

doi:10.1590/s0102-86502008000300004

Cited by 3 publications

(4 citation statements)

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“…As the surgical techniques and the suture materials, other factors interfere in anastomosis quality, as antibiotics 4,5 , antioxidants 6,7 , antineoplasics 8 , imunossupressors 9 , hormones 10 , trauma 11 , shock [12][13][14] , adherences 15,16 and ischemia 17,18 .…”

Section: Introductionmentioning

confidence: 99%

Hyperbaric oxygen therapy and mechanical resistence of the colonics anastomosis in rats with peritonitis

et al. 2010

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Purpose:To analyze the effects of hyperbaric oxygen therapy (HBO) on the mechanical resistance of anastomosis performed in rats' distal colon presenting peritonitis induced by ligature and cecal punction using the Total Energy Rupture biomechanical test (ETR). Methods: It was used 45 rats divided into three groups of 15 animals each. In Control Group (CG), it was performed anastomosis in distal colon without peritonitis. In Peritonitis Group (PG), it was performed anastomosis six hours after the induction of peritonitis by ligature and cecal punction. In Hyperbaric Chamber Group (HCG), it was performed six hours after the induction of peritonitis by ligature and cecal punction. The animals on CG and PG were kept at place air while the animals on HCG were placed on an experimental hyperbaric chamber in order to inhale oxygen at 100%, two absolute atmospheres, for 120 minutes, for four consecutive days. Euthanasia took place on the fifth day of the experiment. All the animals underwent to Total Energy Rupture Biomechanical Resistance test (ETR). Total Energy Rupture was defined as the necessary internal energy stored up to promote the colon rupture after an external traction force imposition. Results: The Peritonitis Group presents smaller average ETR than Control Group. There was no statistical difference between Peritonitis Group and Hyberbaric Chamber Group. Conclusion: Hyperbaric oxygen therapy did not alter the mechanical resistance of anastomosis performed in distal colon of rats under the presence of peritonitis induced by ligature and cecal puncture. Key words: Anastomosis, Surgical. Colon. Hyperbaric Oxygenation. Peritonitis. Rats. RESUMO Objetivo:Analisar o efeito da oxigenoterapia hiperbárica (HBO) sobre a resistência mecânica de anastomoses realizadas em cólon distal de ratos na presença de peritonite induzida por ligadura e punção cecal utilizando o teste biomecânico de Energia Total de Ruptura (ETR). Métodos: Foram utilizados 45 ratos distribuídos em três grupos de 15 animais. No Grupo Controle (GC), realizou-se anastomose no cólon distal sem peritonite. No Grupo Peritonite (GP), realizou-se anastomose seis horas após a indução da peritonite por ligadura e punção cecal. No Grupo Câmara Hiperbárica (GCH), realizou-se anastomose seis horas após a indução da peritonite por ligadura e punção cecal. Os animais dos GC e GP foram mantidos em ar ambiente. Os animais do GCH foram colocados em uma câmara hiperbárica experimental para inalarem oxigênio a 100%, a duas atmosferas absolutas, durante 120 minutos, por quatro dias consecutivos. A eutanásia ocorreu no quinto dia do experimento. Todos os animais foram submetidos ao Teste de Resistência Biomecânico Energia Total de Ruptura (ETR). A Energia Total de Ruptura foi definida como a energia interna acumulada necessária para promover o rompimento do cólon após a imposição de uma força externa de tração. Resultados: O Grupo Peritonite apresentou menor média de ETR que o Grupo Controle. Não houve diferença estatística entre o Grupo Peritonite e o Grupo C...

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Section: Introductionmentioning

confidence: 99%

Hyperbaric oxygen therapy and mechanical resistence of the colonics anastomosis in rats with peritonitis

et al. 2010

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“…The increasing interest in the factors involved in the healing of intestinal anastomoses is due to serious secondary clinical effects to the occurrence of dehiscence, increasing length of hospital stay and mortality 1 . In the gastrointestinal tract, the submucosa is the layer that provides the most part of strength of intestinal anastomoses.…”

Section: Introductionmentioning

confidence: 99%

“…The reduced blood flow as a result of shock is a leading cause of failure in the healing of intestinal anastomosis, once the healing process is directly related to perfusion in the suture line 9 . Shock is defined as a circulatory dysfunction that causes tissue hypoxia 1 . Other definition addresses the shock syndrome as a sequence of events initiated by an aggressor factor, followed by endocrine-metabolic responses and failure of maintenance of homeostasis mechanisms, with decreased tissue perfusion 7 .…”

Section: Introductionmentioning

confidence: 99%

“…These, on the other hand, decreases the immune function of macrophages and lymphocytes, causing immunosuppression and increased risk of infection . There may be also stimulus to the release of toxins and bacterial translocation, which, associated with the duration of the inflammatory process, may produce irreversible changes in the tissues, causing reduced ability of intestinal absorption and inhibition of wound healing 1,10 .…”

Section: Introductionmentioning

confidence: 99%

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Effect of hemorrhagic shock on intestinal anastomoses’ healing

Oliveira¹,

Cabral²,

Silva³

et al. 2015

J Surg Clin Res

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Background/Purpose: Hypovolemia and shock is increasingly frequent in the perioperative of intestinal anastomoses, especially due to abdominal trauma. The aim of this study is to evaluate the effects of hemorrhagic shock in the healing of intestinal anastomoses in rats. Methods: It was analyzed the shock interference on the strength of ileum anastomoses. Histologically, structural changes of the anastomotic segments were assessed by two pathologists. Data are given as mean ± SEM. The animals were randomly selected and assigned in two groups with six rats each: Group 1-rats with hypovolemic shock (shocked+enterectomy) treated with fresh whole blood. Group 2-rats not shocked, untreated + enterectomy. Results: The intestinal anastomosis bursting pressure of shock+enterectomy group rats was lower than in the unshocked+enterectomy group, and the difference was significant (p=0.001). In the hemorrhagic shock+enterectomy group rats the density of collagen and fibrous tissue was lower and inflammation/foreign body reaction was higher than in the unshocked+enterectomy group, featuring a more immature and deficient healing. Conclusion: In conclusion, the results show that the hypovolemic shock affects the ileum wound healing, causing a decrease in the bursting pressure (mmHg) of ileal anastomosis, leading to the fragility of the surgical wound.

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Coconut water as a resuscitation fluid and their effect on colon anastomosis healing in rats with hemorrhagic shock

Felipe

Nascimento²,

Souza³

et al. 2015

J Surg Clin Res

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Background/purpose: The hemorrhage and shock are important predictors of mortality and a serious complication particularly found in the perioperative colorectal surgery. Currently, there is no ideal fluid for volume replacement in shock. Relevant knowledge on the composition of coconut water (CW) is available, but studies on its use for resuscitation in shock are scarce. The aim of this study is to examine the influence of CW as a resuscitation fluid on the healing of colonic anastomosis in a model of hemorrhagic shock induced in rats. Methods: We used three groups of Wistar rats (6 each), weighing 251±18g. In group 1, rats were shocked and treated with Ringer lactate (RL); in Group 2, shocked rats were treated with modified CW (3% Na); Group 3 rats were not shocked and untreated (control). Results: The average rupture pressures of anastomoses were higher in the group submitted to hemorrhagic shock and treated with CW (190.5±7.5 mmHg) than in rats subjected to shock and treated with RL (159.2±6.6 mmHg). This difference was significant (p<0.05); in the control group the rupture pressure was 186.8±5.6mmHg. Comparing with the group treated with CW, the difference was not significant (p>0.05). Histopathological analysis showed better healing wounds in the group treated with CW, although the differences were not statistically significant comparing with the other groups. Conclusion: The data from this study showed that the volume replacement with CW with 3% sodium influenced positively the healing of colonic anastomoses in rats submitted to hemorrhagic shock model.

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Hemorrhagic shock influence on colonic anastomoses in rats: evaluation of rupture by liquid distension resistance test

Cited by 3 publications

References 10 publications

Hyperbaric oxygen therapy and mechanical resistence of the colonics anastomosis in rats with peritonitis

Hyperbaric oxygen therapy and mechanical resistence of the colonics anastomosis in rats with peritonitis

Effect of hemorrhagic shock on intestinal anastomoses’ healing

Coconut water as a resuscitation fluid and their effect on colon anastomosis healing in rats with hemorrhagic shock

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