Mesenteric traction syndrome in pigs: A single-blinded, randomized controlled trial

Area of Science:

• Surgical Physiology
• Gastrointestinal Surgery
• Hemodynamics

Background:

• Mesenteric traction syndrome is a known complication of upper abdominal surgery.
• Prostacyclin (PGI2) release from the gut is suspected to cause hypotension, tachycardia, and flushing.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) are hypothesized to inhibit PGI2 and stabilize hemodynamics.

Purpose of the Study:

• To investigate the effect of mesenteric traction on splanchnic blood flow in pigs.
• To determine if NSAID administration (ketorolac) can mitigate the cardiovascular response to mesenteric traction.

Main Methods:

• Pigs were randomized to receive ketorolac or a placebo.
• Mesenteric traction was applied for five minutes.
• Hemodynamic variables and regional blood flow were measured using laser speckle contrast imaging and laser Doppler flowmetry.

Main Results:

• Mesenteric traction led to decreased systemic vascular resistance, mean arterial blood pressure, and gastric antrum blood flow in both groups.
• Plasma 6-keto-PGF1α levels, a prostacyclin metabolite, did not increase.
• Cardiac output, heart rate, central venous pressure, and blood flow to other organs remained unchanged.

Conclusions:

• Mesenteric traction causes cardiovascular depression and reduced gastric blood flow.
• Ketorolac did not alter the cardiovascular response to mesenteric traction.
• Further research is needed to identify the specific mediator of this response.