Abstract
Introduction and objectivesBacterial translocation (BT) is the passage of viable bacteria or endotoxins from the gastrointestinal lumen to extra-luminal tissues and is usually observed after intestinal ischaemia-reperfusion injury. The aim of this study was to investigate post-resuscitation BT after cardiac arrest and resuscitation in a swine anaesthetized with propofol-based total intravenous anaesthesia.Materials and methodsEighteen female Landrace/Large White piglets were randomly divided into control (CON), cardiac arrest (CA) and cardiac arrest-cardiopulmonary resuscitation (CA-CPR) groups. In the CON group, the animals were only monitored for two hours. In the CA group, the animals were not resuscitated and underwent necropsy immediately after cardiac arrest. In the CA-CPR group, the animals were resuscitated until the return of spontaneous circulation (ROSC) and were monitored for two hours. The animals of the CON and CA-CPR groups underwent necropsy 24 hours later. Bacterial translocation was assessed by blood and tissue cultures and endotoxin measurement in the portal and systemic circulation. Malondialdehyde content calculation and histological analysis of the intestine were performed in order to estimate ischemia and reperfusion (I/R) tissue damage.Results Malondialdehyde content, an indicator of oxidative stress, was significantly higher in the CA-CPR group compared to the CA in homogenized ileum (p=0.016). Malondialdehyde content in homogenized colon revealed significantly higher levels in the CA-CPR group compared to the CON (p=0.004) and the CA group (p=0.016). We found significantly higher levels of portal endotoxin in the CA-CPR group compared to the CON (p=0.026) and the CA group (p=0.026). The number of positive mesenteric lymph nodes cultures for E. coli was greater in the CA-CPR group, followed by the CA and CON groups, although the difference was not significant (67%, 33%, and 33%, respectively; p=0.407).ConclusionsMalondialdehyde content and portal endotoxin levels do not increase during the cardiac arrest interval, but only after CPR and ROSC. Although the number of positive MLNs cultures was greater in the CA-CPR animals, no statistically significant differences were observed between the three groups due to the short monitoring period.
Highlights
Introduction and objectivesBacterial translocation (BT) is the passage of viable bacteria or endotoxins from the gastrointestinal lumen to extra-luminal tissues and is usually observed after intestinal ischaemia-reperfusion injury
We found significantly higher levels of portal endotoxin in the cardiac arrest (CA)-CPR group compared to the CON (p=0.026) and the CA group (p=0.026)
The number of positive mesenteric lymph nodes cultures for E. coli was greater in the cardiac arrest-cardiopulmonary resuscitation (CA-CPR) group, followed by the CA and CON groups, the difference was not significant (67%, 33%, and 33%, respectively; p=0.407)
Summary
Introduction and objectivesBacterial translocation (BT) is the passage of viable bacteria or endotoxins from the gastrointestinal lumen to extra-luminal tissues and is usually observed after intestinal ischaemia-reperfusion injury. How to cite this article Tassopoulos A, Chalkias A, Papalois A, et al (September 10, 2020) Assessment of Post-Resuscitation Intestinal Injury and Timing of Bacterial Translocation in Swine Anaesthetized With Propofol-Based Total Intravenous Anaesthesia. Bacterial translocation (BT) is the passage of viable bacteria or endotoxins from the gastrointestinal lumen, through the mucosal epithelium, to extra-luminal tissues, such as the mesenteric lymph nodes (MLNs) and other distant organs [5,6,7]. This phenomenon is usually observed after intestinal ischemia-reperfusion (I/R) injury, but the timing and the associated pathophysiological mechanisms have been poorly investigated after cardiac arrest and resuscitation
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