Effect of ulinastatin combined with mild therapeutic hypothermia on intestinal barrier dysfunction following cardiopulmonary resuscitation in rats

Abstract

The aim of the present study was to investigate the effect of ulinastatin (UTI) alone or combined with mild therapeutic hypothermia (MTH) on intestinal barrier dysfunction following cardiopulmonary resuscitation (CPR) in rats. A total of 25 adult male Sprague-Dawley rats were randomly organized into five groups: Sham; control; UTI; MTH; and the combined group. The latter four groups were induced with the asphyxiated cardiac arrest rat model and treated with different interventions. After 6 h of treatment, the intestinal tissues of the rats were examined by electron microscopy, and the levels of intestinal malondialdehyde (MDA) and superoxide dismutase (SOD) were determined. The results of the present study indicated that the target temperature had successfully been attained in MTH and the combined group, and the other three groups of rats all survived at a normal temperature. In the rats treated with UTI or MTH, the epithelial cells exhibited pathological changes in their tight junctions and epithelial cell surface microvilli compared with the sham group. In the rats treated with a combination of UTI and MTH, whilst the epithelial cells exhibited a few slight changes, including mitochondrial edema, they were largely similar to the normal epithelial cells. However, there were significant differences in the levels of MDA and SOD between the different treatment groups. UTI combined with MTH may serve a protective role by suppressing oxidative stress in the small intestinal mucosa following CPR in rats compared with either UTI or MTH treatment alone.

Fluid Management in Veno-Arterial Extracorporeal Membrane Oxygenation Therapy—Analysis of an Experimental Pig Model

“…In a clinical setting, intestinal dysfunction is of subordinate relevance next to cardiac, pulmonary, and cerebral failure and their importance in ECMO therapy. In regard to therapeutic measures, medication with ulinastatin is currently a topic of interest in ischemia-induced intestinal barrier dysfunction [ 40 ]. Ulinastatin is a serine protease inhibitor that has anti-inflammatory characteristics and has been widely used as a treatment for patients with inflammatory disorders.…”

Fast Hypothermia Induced by Continuous Renal Replacement Therapy Alleviates Renal and Intestinal Injury after Cardiac Arrest in Swine

“…And the levels of MDA and SOD in tissues were also determined in our study. MDA, a substance produced by reactive oxygen after degrading polyunsaturated lipids and may lead to intracellular toxic stress, is an indicator of oxidative stress, while SOD is a pivotal antioxidant in cells [13]. With a smaller elevation of MDA and larger elevation of SOD, CRRT cooling may alleviate the renal and intestinal injury by suppressing oxidative stress.…”

“…Hasslacher et al [11] showed that TH had a protective effect against the development and recovery of AKI, accompanied by lower levels of creatinine (Cr) and cystatin C. With regard to the role of TH on intestinal injury, a study showed TH alone or in the combination with sevo urane could affect small intestinal protein expression and activity, and the proteins might be involved in intestinal I/R injury following resuscitation [12]. Another study showed that ulinastatin combined with TH might exert a protective effect in the small intestinal mucosa by decreasing oxidative stress in a rat model [13].…”

Fast Hypothermia Induced by Continuous Renal Replacement Therapy Alleviates Renal and Intestinal Injury After Cardiac Arrest in Swine

“…A previous study demonstratedthat24hr of TH after CPR was associated with a delayed improvement in renal function [10].Hasslacher et al [11] showed that TH had a protective effect against the development and recovery of AKI, accompanied by lower levels of creatinine (Cr) and cystatin C. With regard to the role of TH on intestinal injury, a study showed TH alone or in the combination with sevo urane could affect small intestinal protein expression and activity, and the proteins might be involved in intestinal I/R injury following resuscitation [12]. Another study showed that ulinastatincombined with TH mightexert a protective effect in the small intestinal mucosa by decreasing oxidative stress in a rat model [13].…”