RESUMEN
PURPOSE: Vogt´s antioxidant solution (red blood cells, Ringer's solution, sodium bicarbonate, mannitol, allopurinol and 50% glucose) or its modification including hydroxyethyl starch (HES) were tested for the prevention of splanchnic artery occlusion shock. METHODS: Seventy rats were distributed in treatment (3), control (1), and sham (3) groups. Ischemia and reperfusion were induced by celiac, superior mesenteric and inferior mesenteric arteries occlusion for 40 min, followed by 60 min reperfusion or sham procedures. Controls received saline, both treatment and sham groups received the Vogt's solution, modified Vogt's solution (replacing Ringer's solution by HES), or HES. Mean arterial blood pressure (MABP), ileal malondialdehyde (MDA) and plasmatic MDA were determined, and a histologic grading system was used. RESULTS: At reperfusion, MABP dropped in all I/R groups. Only HES treatment was able to restore final MABP to the levels of sham groups. Plasmatic MDA did not show differences between groups. Ileum MDA was significantly higher in the control and treatment groups as compared to the sham group. Histology ranking was higher in the only in control group. CONCLUSIONS: Hydroxyethyl starch was able to prevent hemodynamic shock but not intestinal lesions. Both treatments with Vogt's solutions did not show any improvement. .
Asunto(s)
Animales , Masculino , Derivados de Hidroxietil Almidón/farmacología , Arterias Mesentéricas/efectos de los fármacos , Oclusión Vascular Mesentérica/prevención & control , Sustitutos del Plasma/farmacología , Daño por Reperfusión/prevención & control , Modelos Animales de Enfermedad , Hemodinámica/efectos de los fármacos , Derivados de Hidroxietil Almidón/uso terapéutico , Íleon/irrigación sanguínea , Íleon/patología , Isquemia/prevención & control , Soluciones Isotónicas/farmacología , Soluciones Isotónicas/uso terapéutico , Malondialdehído/análisis , Arterias Mesentéricas/patología , Oclusión Vascular Mesentérica/patología , Sustitutos del Plasma/uso terapéutico , Ratas Wistar , Reproducibilidad de los Resultados , Circulación Esplácnica/efectos de los fármacos , Factores de Tiempo , Resultado del TratamientoRESUMEN
A isquemia intestinal é uma emergência pouco frequente em cirurgia vascular. As principais causas dessa doença são as embolias e as tromboses arteriais. A isquemia, por si só, é bastante lesiva, mas a reperfusão do tecido isquêmico pode levar a uma série de complicações, que podem aumentar as lesões teciduais e, associado às complicações sistêmicas, colocar em risco a vida do paciente. As lesões decorrentes da isquemia e reperfusão em tecido intestinal foram demonstradas em estudos clínicos e experimentais, nos quais estudou-se também a fisiopatologia e os tratamentos adequados. Esses estudos foram feitos em grande variedade de modelos experimentais, e, consequentemente, os resultados encontrados foram bastante contraditórios...