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Increased survival from peritonitis after blockade of transdiaphragmatic absorption of bacteria
Abstract:
Based upon the knowledge that bacteria in the peritoneal cavity gain access to circulating blood by way of transdiaphragmatic absorption into lymph, a study was carried out to determine whether this absorption protects or endangers the host. Blockade of absorption produced by intraperitoneal (IP) injection of platelet rich plasma (PRP) or by scarification of the peritoneal surface of the diaphragm increased survival time in rats with double colonic perforation from 20 per cent in control rats to 86 and 93 per cent, respectively. Each of these maneuvers significantly increased the number of negative blood culture findings.
Insights
Blocking bacterial absorption from the peritoneal cavity into the bloodstream significantly improved survival rates in rats with colonic perforation. This suggests transdiaphragmatic absorption endangers the host during infection.
Area of Science:
- Immunology
- Surgical Infection
- Gastroenterology
Background:
- Bacteria in the peritoneal cavity can enter the bloodstream via transdiaphragmatic lymphatic absorption.
- The role of this absorption pathway in host protection or endangerment during infection is unclear.
Purpose of the Study:
- To investigate whether blocking transdiaphragmatic absorption impacts host survival in a model of intra-abdominal infection.
- To determine if impeding lymphatic uptake of bacteria influences the outcome of sepsis.
Main Methods:
- Rats underwent double colonic perforation to induce peritonitis.
- Absorption blockade was achieved via intraperitoneal injection of platelet-rich plasma (PRP) or diaphragmatic scarification.
- Survival rates and blood culture results were monitored in control and treatment groups.
Main Results:
- Blockade of transdiaphragmatic absorption significantly increased survival time in rats with colonic perforation.
- Survival increased from 20% in controls to 86% with PRP and 93% with diaphragmatic scarification.
- Negative blood cultures were more frequent in rats with absorption blockade.
Conclusions:
- Transdiaphragmatic absorption of bacteria from the peritoneal cavity appears to be detrimental to the host.
- Interfering with this absorption pathway offers a protective survival benefit in experimental peritonitis.
- Targeting lymphatic absorption may represent a novel therapeutic strategy for intra-abdominal infections.