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Updated: Apr 23, 2026
A Reproducible Intensive Care Unit-Oriented Endotoxin Model in Rats
Published on: February 20, 2021
Bacterial translocation and endotoxemia after pringle maneuver in cirrhotic rats
Yonghui Su1, Haiyan Pan, Zhaowang Guo
1Department of General Surgery, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, 519000, Guangdong, China, suyh@mail.sysu.edu.cn.
Background:
Pringle maneuver (Pm) is advocated for the reduction of blood loss during liver surgery, while postoperative infections continue to be a frequent complication after hepatic resection and liver transplantation.
Aim:
To investigate the effect of the Pringle maneuver on systemic bacterial translocation and endotoxemia in cirrhotic rats and cirrhotic rats with selective intestinal decontamination.
Methods:
A total of 100 male Sprague-Dawley cirrhotic rats were randomly divided into five equal groups: sham operation, Pm of 10 min, Pm of 20 min, Pm of 30 min, and pretreatment. Tissue samples from mesenteric lymph nodes, liver, lungs, portal, and vena cava vein blood were obtained for culture after 30 min and 24 h of the operation. Endotoxin levels were measured in portal vein and vena cava blood.
Results:
Portal vein and vena cava blood endotoxin concentrations increased significantly after 30 min, especially 24 h of operation in the Pm of 20 min and Pm of 30 min groups. A significant increase in contaminated mesenteric lymph nodes, liver, portal, and vena cava blood was noted 24 h later. The incidence of gut bacterial translocation increased with the duration extension of Pm. Escherichia coli was the most common bacteria isolated from the tissues. There was a significant decrease of portal vein and vena cava blood endotoxin concentrations and the incidence of bacterial translocation by selective intestinal decontamination.
Conclusions:
There is endotoxemia immediately after Pringle maneuver and gut bacteria translocation 24 h later. The incidence of gut bacterial translocation increases with the duration extension of Pm. Selective intestinal decontamination can decrease bacteria translocation and endotoxemia.
Insights
The Pringle maneuver in cirrhotic rats increases bacterial translocation and endotoxemia, especially with longer durations. Selective intestinal decontamination effectively reduces these risks during liver surgery.
Area of Science:
- Hepatobiliary Surgery
- Surgical Complications
- Microbiology
Background:
- The Pringle maneuver (Pm) is used to reduce blood loss in liver surgery.
- Postoperative infections remain a common complication after liver resection and transplantation.
Purpose of the Study:
- To assess the impact of the Pringle maneuver (Pm) on systemic bacterial translocation and endotoxemia.
- To evaluate the efficacy of selective intestinal decontamination in mitigating these effects in cirrhotic rats.
Main Methods:
- 100 cirrhotic rats underwent sham operation or Pringle maneuver (10, 20, or 30 min).
- Bacterial cultures and endotoxin levels were measured in blood and tissues at 30 min and 24 h.
- One group received selective intestinal decontamination prior to the procedure.
Main Results:
- Pringle maneuver significantly increased endotoxin levels and bacterial translocation, particularly with longer durations (20 and 30 min).
- Gut bacterial translocation incidence correlated with Pringle maneuver duration.
- Selective intestinal decontamination markedly reduced endotoxemia and bacterial translocation.
Conclusions:
- Endotoxemia occurs immediately after the Pringle maneuver, with bacterial translocation observed 24 hours later.
- Prolonged Pringle maneuver duration exacerbates bacterial translocation.
- Selective intestinal decontamination is a viable strategy to reduce bacterial translocation and endotoxemia post-Pringle maneuver.
