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Postburn gastrointestinal vasoconstriction increases bacterial and endotoxin translocation
R Tokyay1, S T Zeigler, D L Traber
1Department of Surgery, Shriners Burns Institute, Galveston, Texas.
Journal of Applied Physiology (Bethesda, Md. : 1985)
|April 1, 1993
Summary
Major burns cause temporary splanchnic vasoconstriction, leading to reduced intestinal blood flow and oxygen. This increases gut bacterial translocation and endotoxin absorption, impacting systemic circulation.
Area of Science:
- Gastroenterology
- Trauma Surgery
- Critical Care Medicine
Background:
- Splanchnic ischemia is linked to bacterial translocation and increased gut endotoxin absorption.
- The impact of major burns on splanchnic circulation requires further investigation.
Purpose of the Study:
- To investigate the effects of major burn injury on splanchnic circulation dynamics.
- To assess the association between burn-induced splanchnic changes and bacterial translocation.
Main Methods:
- Minipigs underwent 40% flame burn or sham burn with appropriate fluid resuscitation.
- Measurements included mesenteric blood flow, oxygen delivery/consumption, intestinal mucosal pH, and endotoxin levels.
- Systemic tissues were cultured, and histopathological analysis was performed post-injury.
Main Results:
- Major burns induced transient splanchnic vasoconstriction, decreasing mesenteric blood flow and intestinal mucosal pH.
- Mesenteric oxygen delivery was reduced, while oxygen consumption remained unchanged early postburn.
- Elevated endotoxin levels and increased bacterial translocation were observed in burn-injured animals.
Conclusions:
- Major burns trigger a transient, selective splanchnic vasoconstriction.
- This vasoconstriction is associated with intestinal mucosal acidosis and increased bacterial translocation.
- Burn injury promotes gut-derived endotoxin absorption into systemic circulation.