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Protective Effects of Pentoxifylline on Peripheral Microcirculatory Dysfunction and Renal Cortical Oxygen Deficiency
Bülent Ergin1, H Rob Taal2, Deniz Erol Kutucu3
1Department of Intensive Care Adult, Laboratory of Translational Intensive Care, Erasmus Medical Center, Erasmus University Rotterdam, Rotterdam, the Netherlands.
Objective:
Sepsis is associated with hypotension, tissue hypoperfusion, and microcirculatory dysfunction leading to multi-organ failure and mortality. Pentoxifylline (PTX), a phosphodiesterase inhibitor, is reported to improve blood flow and viscosity. The aim of this study was to investigate the efficacy of PTX on peripheral and renal microcirculatory alterations in sepsis.
Methods:
Fully instrumented Wistar albino rats were randomized as the control group (only surgery), only lipopolysaccharide (LPS) group without treatment (T1), LPS group with PTX treatment (LPS + PTX), LPS group treated with only fluid resuscitation (Ringer's acetate; RA), LPS + RA, LPS group with combined treatment with PTX and RA (LPS + PTX + RA) for 3 h (T2, T3 and T4). The systemic hemodynamics, renal oxygenation, leg muscle microcirculation, histological damage, and inflammatory and endothelial injury markers were analyzed.
Results:
The renal cortical microvascular oxygen pressure (cμPO2) was improved by the PTX, RA, and PTX + RA treatments compared to the LPS group (p < 0.05). The proportions of perfused vessels (PPV) and red blood cell velocity (RBCv) were significantly restored by PTX and RA compared with the LPS group at T4 (p < 0.05). Renal damage and inflammatory cell infiltration were reduced by PTX and RA together compared with RA alone (p < 0.05).
Conclusion:
In this study, we found that PTX may protect renal oxygenation, peripheral (muscle) microcirculation, renal damage, and tissue inflammatory cell infiltration in a rat model of LPS-induced sepsis.
