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Ischemia/reperfusion injury in porcine intestine - Viability assessment

AIM: To investigate viability assessment of segmental small bowel ischemia/reperfusion in a porcine model. METHODS: In 15 pigs, five or six 30-cm segments of jejunum were simultaneously made ischemic by clamping the mesenteric arteries and veins for 1 to 16 h. Reperfusion was initiated after differe...

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Autores principales: Strand-Amundsen, Runar J, Reims, Henrik M, Reinholt, Finn P, Ruud, Tom E, Yang, Runkuan, Høgetveit, Jan O, Tønnessen, Tor I
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5949714/
https://www.ncbi.nlm.nih.gov/pubmed/29760544
http://dx.doi.org/10.3748/wjg.v24.i18.2009
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author Strand-Amundsen, Runar J
Reims, Henrik M
Reinholt, Finn P
Ruud, Tom E
Yang, Runkuan
Høgetveit, Jan O
Tønnessen, Tor I
author_facet Strand-Amundsen, Runar J
Reims, Henrik M
Reinholt, Finn P
Ruud, Tom E
Yang, Runkuan
Høgetveit, Jan O
Tønnessen, Tor I
author_sort Strand-Amundsen, Runar J
collection PubMed
description AIM: To investigate viability assessment of segmental small bowel ischemia/reperfusion in a porcine model. METHODS: In 15 pigs, five or six 30-cm segments of jejunum were simultaneously made ischemic by clamping the mesenteric arteries and veins for 1 to 16 h. Reperfusion was initiated after different intervals of ischemia (1-8 h) and subsequently monitored for 5-15 h. The intestinal segments were regularly photographed and assessed visually and by palpation. Intraluminal lactate and glycerol concentrations were measured by microdialysis, and samples were collected for light microscopy and transmission electron microscopy. The histological changes were described and graded. RESULTS: Using light microscopy, the jejunum was considered as viable until 6 h of ischemia, while with transmission electron microscopy the ischemic muscularis propria was considered viable until 5 h of ischemia. However, following ≥ 1 h of reperfusion, only segments that had been ischemic for ≤ 3 h appeared viable, suggesting a possible upper limit for viability in the porcine mesenteric occlusion model. Although intraluminal microdialysis allowed us to closely monitor the onset and duration of ischemia and the onset of reperfusion, we were unable to find sufficient level of association between tissue viability and metabolic markers to conclude that microdialysis is clinically relevant for viability assessment. Evaluation of color and motility appears to be poor indicators of intestinal viability. CONCLUSION: Three hours of total ischemia of the small bowel followed by reperfusion appears to be the upper limit for viability in this porcine mesenteric ischemia model.
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spelling pubmed-59497142018-05-14 Ischemia/reperfusion injury in porcine intestine - Viability assessment Strand-Amundsen, Runar J Reims, Henrik M Reinholt, Finn P Ruud, Tom E Yang, Runkuan Høgetveit, Jan O Tønnessen, Tor I World J Gastroenterol Basic Study AIM: To investigate viability assessment of segmental small bowel ischemia/reperfusion in a porcine model. METHODS: In 15 pigs, five or six 30-cm segments of jejunum were simultaneously made ischemic by clamping the mesenteric arteries and veins for 1 to 16 h. Reperfusion was initiated after different intervals of ischemia (1-8 h) and subsequently monitored for 5-15 h. The intestinal segments were regularly photographed and assessed visually and by palpation. Intraluminal lactate and glycerol concentrations were measured by microdialysis, and samples were collected for light microscopy and transmission electron microscopy. The histological changes were described and graded. RESULTS: Using light microscopy, the jejunum was considered as viable until 6 h of ischemia, while with transmission electron microscopy the ischemic muscularis propria was considered viable until 5 h of ischemia. However, following ≥ 1 h of reperfusion, only segments that had been ischemic for ≤ 3 h appeared viable, suggesting a possible upper limit for viability in the porcine mesenteric occlusion model. Although intraluminal microdialysis allowed us to closely monitor the onset and duration of ischemia and the onset of reperfusion, we were unable to find sufficient level of association between tissue viability and metabolic markers to conclude that microdialysis is clinically relevant for viability assessment. Evaluation of color and motility appears to be poor indicators of intestinal viability. CONCLUSION: Three hours of total ischemia of the small bowel followed by reperfusion appears to be the upper limit for viability in this porcine mesenteric ischemia model. Baishideng Publishing Group Inc 2018-05-14 2018-05-14 /pmc/articles/PMC5949714/ /pubmed/29760544 http://dx.doi.org/10.3748/wjg.v24.i18.2009 Text en ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Basic Study
Strand-Amundsen, Runar J
Reims, Henrik M
Reinholt, Finn P
Ruud, Tom E
Yang, Runkuan
Høgetveit, Jan O
Tønnessen, Tor I
Ischemia/reperfusion injury in porcine intestine - Viability assessment
title Ischemia/reperfusion injury in porcine intestine - Viability assessment
title_full Ischemia/reperfusion injury in porcine intestine - Viability assessment
title_fullStr Ischemia/reperfusion injury in porcine intestine - Viability assessment
title_full_unstemmed Ischemia/reperfusion injury in porcine intestine - Viability assessment
title_short Ischemia/reperfusion injury in porcine intestine - Viability assessment
title_sort ischemia/reperfusion injury in porcine intestine - viability assessment
topic Basic Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5949714/
https://www.ncbi.nlm.nih.gov/pubmed/29760544
http://dx.doi.org/10.3748/wjg.v24.i18.2009
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