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Vascular responsiveness in obstructed gut.

R Neville1, L P Fielding, R P Cambria

  • 1Department of Surgery, West Haven VAMC, New Haven, Connecticut.

Diseases of the Colon and Rectum
|March 1, 1991
PubMed
Summary
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Patients with bowel obstruction exhibit altered gut blood flow responses to vasoactive drugs. This study in an animal model suggests impaired splanchnic vasoconstriction may contribute to multiorgan failure in these patients.

Area of Science:

  • Physiology
  • Surgical Pathophysiology

Background:

  • Multiorgan system failure is a significant cause of mortality in patients with bowel obstruction.
  • Hypotension and sepsis are key contributors to this failure.
  • The underlying pathophysiology, particularly concerning splanchnic circulation, requires further elucidation.

Purpose of the Study:

  • To investigate the pathophysiology of hypotension-induced multiorgan failure in a model of bowel obstruction.
  • To assess the responsiveness of splanchnic blood flow to vasoactive agents in the presence of bowel obstruction.

Main Methods:

  • An animal model of bowel obstruction was established for 5 days.
  • Blood flow in the superior mesenteric artery was measured.
  • The effects of Pitressin and norepinephrine on gut blood flow were evaluated in obstructed and control (sham) animals.

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Main Results:

  • In control animals, Pitressin significantly reduced gut blood flow (52%), while the effect was blunted in obstructed animals (11%, P<0.01).
  • Norepinephrine also showed a reduced effect on gut blood flow in obstructed animals (58%) compared to controls (79%, P<0.05).
  • Splanchnic blood flow remained higher and less responsive to vasoactive drug infusion in obstructed animals.

Conclusions:

  • Bowel obstruction alters splanchnic vascular responsiveness to vasoactive drugs.
  • This diminished responsiveness may contribute to the pathophysiology of multiorgan failure associated with systemic hypotension in bowel obstruction.
  • Findings suggest impaired splanchnic vasoconstriction plays a role in the hemodynamic instability of bowel obstruction.