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Erschienen in:

01.01.2009 | Original

Hypercapnic acidosis minimizes endotoxin-induced gut mucosal injury in rabbits

verfasst von: Hiroshi Morisaki, Satoshi Yajima, Yoko Watanabe, Takeshi Suzuki, Michiko Yamamoto, Nobuyuki Katori, Saori Hashiguchi, Junzo Takeda

Erschienen in: Intensive Care Medicine | Ausgabe 1/2009

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Abstract

Objective

Recent evidence demonstrated that hypercapnic acidosis due to lung protective strategy was not only permissive but also even therapeutic for injured lung. Since the effects of hypercapnic acidosis on extra-pulmonary organs remain to be clarified, we tested the hypothesis that hypercapnic acidosis protects gut mucosal barrier function by modulating inflammation in a rabbit model of endotoxemia.

Design

Prospective randomized animal study.

Setting

University research laboratory.

Subjects

Male New Zealand white rabbits.

Interventions

Thirty-two animals were randomly allocated into two groups: normocapnia (n = 17) and hypercapnia (n = 15). The latter group received F_ICO₂ 5% under mechanical ventilation to achieve hypercapnia throughout the study periods, whereas the former with F_ICO₂ 0%.

Measurements and results

Arterial blood gas, intramucosal pH (pHi) and portal blood flow were assessed at baseline, 2-h and 4-h infusion of lipopolysaccharide. At 4 h, ileal myeloperoxidase (MPO) activity and intestinal permeability were measured. The animals in the hypercapnia group showed apparent hypercapnic acidosis and progressive intramucosal acidosis at 4 h, accompanied by significantly lower intestinal permeability versus normocapnia group. Ileal MPO activity was comparable between the study groups.

Conclusions

Hypercapnic acidosis attenuates endotoxin-induced gut barrier dysfunction possibly through neutrophil-independent mechanisms.

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Amato MB, Barbas CS, Mederios DM, Magaldi RB, Schettino GP, Lorenzi-Fihlo G, Kairalla RA, Deheinzelin D, Munoz C, Oliveira R, Takagaki TY, Carvalho CRR (1998) Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med 338:347–354PubMedCrossRef

ARDS Network (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and acute respiratory distress syndrome. N Engl J Med 342:1301–1308CrossRef

Laffey JG, Tanaka M, Engelberts D, Luo X, Yuan S, Tanswell AK, Post M, Lindsay T, Kavanagh BP (2000) Therapeutic hypercapnia reduces pulmonary and systemic injury following in vivo lung reperfusion. Am J Respir Crit Care Med 162:2287–2294PubMed

Laffey JG, Honan D, Hopkins N, Hyvelin JM, Boylan JF, McLoughlin P (2004) Hypercapnic acidosis attenuates endotoxin-induced acute lung injury. Am J Respir Crit Care Med 169:46–56PubMedCrossRef

Doerr CH, Gajic O, Berrios JC, Caples S, Abdel M, Lymp JF, Hubmayr RD (2005) Hypercapnic acidosis impairs plasma membrane wound resealing in ventilator-injured lungs. Am J Respir Crit Care Med 171:1371–1377PubMedCrossRef

Laffey JG, Engelberts D, Kavanagh BP (2000) Buffering hypercapnic acidosis worsens acute lung injury. Am J Respir Crit Care Med 161:141–146PubMed

Wexeis JC, Myhre ES (1987) Hypocapnia and hypercapnia in the dog: effects on myocardial blood flow and haemodynamics during beta- and combined alpha- and beta-adrenoceptor blockade. Clin Physiol 7:21–33CrossRef

Atkinson JLD, Anderson RE, Sundt TM (1990) The effect of carbon dioxide on the diameter of brain capillaries. Brain Res 517:333–340PubMedCrossRef

Takeshita K, Suzuki Y, Nishio K, Takeuchi O, Toda T, Kudo H, Miyao N, Ishii M, Sato N, Naoki K, Aoki T, Suzuki K, Hiraoka R, Yamaguchi K (2003) Hypercapnic acidosis attenuates endotoxin-induced nuclear factor-κB activation. Am J Respir Cell Mol Biol 29:124–132PubMedCrossRef

10.

O’Croinin D, Chonghaile MN, Higgins B, Laffey JG (2005) Bench-to-bedside review: permissive hypercapnia. Crit Care 9:51–59PubMedCrossRef

11.

Kitakaze M, Weisfeldt ML, Marban E (1988) Acidosis during early reperfusion prevents myocardial stunning in perfused ferret hearts. J Clin Invest 82:920–927PubMedCrossRef

12.

Nomura F, Aoki M, Forbess JM, Mayer JE (1994) Effects of hypercapnic acidotic reperfusion on recovery of myocardial function after cardioplegic ischemia in neonatal lambs. Circulation 90:321–327

13.

Meakins JL, Marshall JC (1986) The gastrointestinal tract: the motor of multiple organ failure. Arch Surg 121:197–201

14.

Kubes P, Hunter JA, Granger DN (1992) Ischemia/reperfusion-induced fenile intestinal dysfunction: importance of granulocyte recruitment. Gastroenterology 103:807–812PubMed

15.

Ai K, Kotake Y, Satoh T, Serita R, Takeda J, Morisaki H (2001) Epidural anesthesia retards progression of intestinal acidosis and increase of portal endotoxin concentrations during acute hypoxia in rabbits. Anesthesiology 94:263–269PubMedCrossRef

16.

Kosugi S, Morisaki H, Satoh T, Ai K, Yamamoto M, Soejima J, Serita R, Kotake Y, Ishizaka A, Takeda J (2005) Epidural analgesia prevents endotoxin-induced gut mucosal injury in rabbits. Anesth Analg 101:265–272PubMedCrossRef

17.

Bennett-Guerrero E, Panah MH, Bodian CA, Methikatam BJ, Alfarone JR, DePerio M, Mythen MG (2000) Automated detection of gastric luminal partial pressure of carbon dioxide during cardiovascular surgery using the Tonocap. Anesthesiology 92:38–45PubMedCrossRef

18.

Otamiri T, Sjödahl R, Tagesson C (1987) An experimental model of studying reversible intestinal ischemia. Acta Chir Scand 153:51–56PubMed

19.

Wang W, Smail N, Wang P, Chaudry IH (1998) Increased gut permeability agter hemorrhage is associated with upregulation of local and systemic IL-6. J Surg Res 79:39–46PubMedCrossRef

20.

Suzuki K, Ota H, Sagawa T, Sakatani T, Fugikura T (1983) Assay method for myeloperoxidase in human polymorphonuclear leukocytes. Anal Biochem 132:345–352PubMedCrossRef

21.

Matute-Bello G, Frevert CW, Kajikawa O, Skerrett SJ, Goodman RB, Park DR, Martin TR (2001) Septic shock and acute lung injury in rabbits with peritonitis. Failure of the neutrophil response to localized infection. Am J Respir Crit Care Med 163:234–243PubMed

22.

Fink MP, Heard SO (1990) Laboratory models of sepsis and septic shock. J Surg Res 49:186–196PubMedCrossRef

23.

Tashkin DP, Goldstein PJ, Simmnons DH (1969) Effect of acute respiratory acidosis on mesenteric circulation of dogs. Am J Physiol 217:1549–1558PubMed

24.

Laffey JG, Jankov RP, Engelberts D, Tanswell AK, Post M, Lindsay T, Mullen JB, Romaschin A, Stephens D, McKerlle C, Kavanagh BP (2003) Effects of therapeutic hypercapnia on mesenteric ischemia-reperfusion injury. Am J Respir Crit Care Med 168:1383–1390PubMedCrossRef

25.

Trzeciak S (2004) Lac-time? Crit Care Med 32:1785–1786PubMedCrossRef

26.

Feihl F, Perret C (1994) Permissive hypercapnia: how permissive should we be? Am J Respir Crit Care Med 150:1722–1737PubMed

27.

Moody W (1984) Effects of intracellular H⁺ on the electrical properties of excitable cells. Ann Rev Neurosci 7:257–278PubMedCrossRef

Titel: Hypercapnic acidosis minimizes endotoxin-induced gut mucosal injury in rabbits
verfasst von: Hiroshi Morisaki
Satoshi Yajima
Yoko Watanabe
Takeshi Suzuki
Michiko Yamamoto
Nobuyuki Katori
Saori Hashiguchi
Junzo Takeda
Publikationsdatum: 01.01.2009
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 1/2009
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1212-7

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Hypercapnic acidosis minimizes endotoxin-induced gut mucosal injury in rabbits