Gut barrier function damage following multiple firearm injuries in a porcine model

Area of Science:

• Trauma research
• Gastrointestinal pathophysiology
• Surgical research

Background:

• Multiple firearm injuries can lead to severe physiological consequences.
• Understanding gut barrier integrity after trauma is crucial for patient outcomes.
• Porcine models offer a relevant platform for studying complex trauma responses.

Purpose of the Study:

• To investigate the characteristics and pathogenesis of gut barrier damage after multiple firearm injuries.
• To compare the effects of single-site versus multiple-site trauma on gut barrier function.
• To evaluate markers of gut ischemia, endotoxemia, and bacterial translocation in a porcine model.

Main Methods:

• Twenty-four pigs were divided into control, single-site (head or femur), and combined multiple-site injury groups.
• Gastric intramucosal pH (pHi), plasma endotoxin, and D-lactate levels were measured.
• Intestinal tissues were examined for pathological changes and diamine oxidase (DAO) activity at 72 hours post-trauma.

Main Results:

• Multiple trauma (group M) showed significantly lower pHi and higher plasma endotoxin and D-lactate levels compared to single-site trauma groups.
• Group M exhibited a higher incidence of positive blood cultures and more severe ileum villus necrosis and exfoliation.
• Ileum diamine oxidase (DAO) activity significantly declined in the multiple trauma group.

Conclusions:

• Multiple trauma can induce gastrointestinal ischemia independent of hemorrhagic shock.
• Gut barrier damage is more severe in multiple trauma, promoting endotoxemia and bacterial translocation.
• These factors contribute to the development of endogenous infections following severe injuries.