Abstract
Purpose
Hypocapnia, a recognized complication of high frequency oscillation ventilation, has multiple adverse effects on lung and brain physiologyin vivo, including potentiation of free radical injury. We hypothesized that hypocapnia would potentiate the effects of mesenteric ischemia-reperfusion on bowel, liver and lung injury.
Methods
Anesthetized male Sprague-Dawley rats were ventilated with high frequency oscillation and were randomized to one of four groups, exposed to either mesenteric ischemia-reperfusion or sham surgery, and to either hypocapnia or normocapnia.
Results
All animals survived the protocol. Ischemia-reperfusion caused significant histologic bowel injury. Bowel 8-isoprostane generation was greater in ischemia-reperfusionvs sham, but was attenuated by hypocapnia. Laser-Doppler flow studies of bowel perfusion confirmed that hypocapnia attenuated reperfusion following ischemia. Plasma alanine transaminase, reflecting overall hepatocellular injury, was not increased by ischemia-reperfusion but was increased by hypocapnia; however, hepatic isoprostane generation was increased by ischemia-reperfusion, and not by hypocapnia. Oxygenation was comparable in all groups, and compliance was impaired by ischemia-reperfusion but not by hypocapnia.
Conclusion
Hypocapnia, although directly injurious to the liver, attenuates ischemia-reperfusion induced lipid peroxidation in the bowel, possibly through attenuation of blood flow during reperfusion.
as]Objectif
L’hypocapnie, complication reconnue de la ventilation par oscillation haute fréquence, a de multiples effets indésirables sur la physiologie pulmonaire et cérébrale in vivo, dont la potentialisation de lésion radicalaire. Nous avons émis l’hypothèse que l’hypocapnie augmenterait les effets d’une ischémie-reperfusion mésentérique sur une lésion de l’intestin, du foie et du poumon.
Méthode
Des rats mâles Sprague-Dawley anesthésiés, ventilés par oscillation haute fréquence, ont été randomisés en quatre groupes, exposés à une ischémie-reperfusion mésentérique ou à une intervention chirurgicale fictive et à l’hypocapnie ou à la normocapnie.
Résultats
Tous les animaux ont survécu. L’ischémie-reperfusion a causé une lésion histologique intestinale significative. La production intestinale de 8-isoprostane a été plus importante avec l’ischémie- reperfusion vs l’opération fictive, mais atténuée par l’hypocapnie. Des études de la perfusion intestinale par laser-Doppler ont confirmé que l’hypocapnie avait diminué la reperfusion après l’ischémie. L’alanine transaminase plasmatique, traduisant la lésion hépatocellulaire globale, n’a pas été augmentée par l’ischémie-reperfusion, mais l’a été par l’hypocapnie; toutefois, la production d’isoprostane hépatique s’est accrue avec ï ischémie-reperfusion, mais non avec l’hypocapnie. L’oxygénation était comparable dans tous les groupes et la compliance a été affectée par ï ischémie-reperfusion, mais non par l’hypocapnie.
Conclusion
L’hypocapnie, quoique directement nuisible au foie, diminue la peroxydation lipidique intestinale induite par l’ischémie-reperfusion, probablement par diminution du débit sanguin pendant la reperfusion.
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Support: Canadian Institutes of Health Research (CIHR).
Dr. Kavanagh is the recipient of a New Investigator Award (CIHR), and a PREA award (Ontario Ministry of Science and Technology).
Dr. Jankov is in receipt of fellowships from the Canadian Institute of Health Research and the Canadian Lung Association. Dr. Tanswell holds the Women’s Auxillary Chair of Neonatology at the Hospital for Sick Children.
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Duggan, M., Engelberts, D., Jankov, R.P. et al. Hypocapnia attenuates mesenteric ischemia-reperfusion injury in a rat model. Can J Anesth 52, 262–268 (2005). https://doi.org/10.1007/BF03016061
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DOI: https://doi.org/10.1007/BF03016061