Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model

PURPOSE: Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. METHODS: Wistar rats were randomly assigned to five groups: control (anesthesia only), laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFalpha, IL-1beta, IL-6 were determined in intraperitoneal fluid (by ELISA). Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. RESULTS: Peritoneal TNFalpha, IL-1beta and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (p<0.05). TNFalpha, IL-1beta and IL-6 expression was lower in the laparoscopic than in laparotomic sepsis (p<0.05). Rats from laparoscopic cecum ligation and puncture group developed significant hypercarbic acidosis in blood and subperitoneal fluid when compared to open procedure group. Total white blood cells and lymphocytes were significantly lower in laparoscopic cecum ligation and puncture rats than in the laparotomic (p<0.01). Nevertheless, the laparotomic cecum ligation rats had a significant increase in blood neutrophils and eosinophils when compared with controls (p<0.05). CONCLUSIONS: This study demonstrates that the CO2 pneumoperitoneum reduced the inflammatory response in an animal model of peritonitis with respect to intraperitoneal cytokines, white blood cell count and clinical correlates of sepsis. The pneumoperitoneum produced hypercarbic acidosis in septic animals.

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Acute pulmonary effects of aerosolized nicotine

AJP Lung Cellular and Molecular Physiology ◽

10.1152/ajplung.00564.2017 ◽

2019 ◽

Vol 316 (1) ◽

pp. L94-L104 ◽

Cited By ~ 21

Author(s):

Shama Ahmad ◽

Iram Zafar ◽

Nithya Mariappan ◽

Maroof Husain ◽

Chih-Chang Wei ◽

...

Keyword(s):

Electronic Cigarettes ◽

White Blood Cells ◽

Weight Ratio ◽

Airway Epithelial Cells ◽

Mrna Levels ◽

Safe Alternative ◽

Arterial Blood ◽

Dose Dependent Increase ◽

Dose Dependent ◽

E Cadherin

Nicotine is a highly addictive principal component of both tobacco and electronic cigarette that is readily absorbed in blood. Nicotine-containing electronic cigarettes are promoted as a safe alternative to cigarette smoking. However, the isolated effects of inhaled nicotine are largely unknown. Here we report a novel rat model of aerosolized nicotine with a particle size (~1 μm) in the respirable diameter range. Acute nicotine inhalation caused increased pulmonary edema and lung injury as measured by enhanced bronchoalveolar lavage fluid protein, IgM, lung wet-to-dry weight ratio, and high-mobility group box 1 (HMGB1) protein and decreased lung E-cadherin protein. Immunohistochemical analysis revealed congested blood vessels and increased neutrophil infiltration. Lung myeloperoxidase mRNA and protein increased in the nicotine-exposed rats. Complete blood counts also showed an increase in neutrophils, white blood cells, eosinophils, and basophils. Arterial blood gas measurements showed an increase in lactate. Lungs of nicotine-inhaling animals revealed increased mRNA levels of IL-1A and CXCL1. There was also an increase in IL-1α protein. In in vitro air-liquid interface cultures of airway epithelial cells, there was a dose dependent increase in HMGB1 release with nicotine treatment. Air-liquid cultures exposed to nicotine also resulted in a dose-dependent loss of barrier as measured by transepithelial electrical resistance and a decrease in E-cadherin expression. Nicotine also caused a dose-dependent increase in epithelial cell death and an increase in caspase-3/7 activities. These results show that the nicotine content of electronic cigarettes may have adverse pulmonary and systemic effects.

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Mechanism of hemoglobin-induced protection against endotoxemia in rats: a ferritin-independent pathway

AJP Lung Cellular and Molecular Physiology ◽

10.1152/ajplung.1997.272.2.l268 ◽

1997 ◽

Vol 272 (2) ◽

pp. L268-L275 ◽

Cited By ~ 14

Author(s):

L. Otterbein ◽

B. Y. Chin ◽

S. L. Otterbein ◽

V. C. Lowe ◽

H. E. Fessler ◽

...

Keyword(s):

Tissue Injury ◽

Lethal Dose ◽

White Blood Cells ◽

Serum Lactate ◽

Serum Lactate Dehydrogenase ◽

Heme Oxygenase 1 ◽

Necrosis Factor Alpha ◽

Physiological Basis ◽

Arterial Blood ◽

Normal Mean

Hemoglobin (Hb) induces heme oxygenase-1 (HO-1), which catalyzes the breakdown of heme to bilirubin, and ferritin. Rats pretreated with Hb have been shown to survive lethal doses of lipopolysaccharide (LPS; see L. Otterbein, S. L. Sylvester, and A. M. Choi. Am. J. Respir. Cell Mol. Biol. 13: 595-601, 1995). The physiological basis of this increased survival and the mechanism(s) involved in the protection against LPS by Hb are unknown. Here we investigated 1) the effects of Hb on the hemodynamic and biochemical parameters of LPS-induced tissue injury and 2) the mechanism(s) by which Hb conferred protection against shock and tissue injury. Hb-treated rats maintained normal mean arterial blood pressure, whereas control rats experienced cardiovascular collapse after a lethal dose of LPS. Hepatic and renal functions, peripheral white blood cells, serum lactate dehydrogenase, and phosphate also remained normal after LPS in Hb-treated rats. Hb also attenuated LPS-induced neutrophil alveolitis and tumor necrosis factor-alpha levels. Pretreatment with both desferoxamine, which, like ferritin, can bind iron, and with exogenous apoferritin failed to protect against LPS. In contrast, treatment with Hb plus desferoxamine, which induced HO-1 but not ferritin, did protect against LPS. Treatment with iron-dextran, which induced ferritin but not HO-1, did not protect against LPS. We conclude that Hb pretreatment reduces the inflammatory and physiological consequences of LPS and that the Hb-induced protection against LPS is dependent on HO-1 and not ferritin induction.

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Risk Factors for Rebleeding after Emergency Endoscopic Treatment of Dieulafoy Lesion

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2020/2385214 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Yongkang Lai ◽

Jianfang Rong ◽

Zhenhua Zhu ◽

Wangdi Liao ◽

Bimin Li ◽

...

Keyword(s):

Risk Factors ◽

Prothrombin Time ◽

Endoscopic Treatment ◽

Endoscopic Therapy ◽

Leukocyte Count ◽

White Blood Cells ◽

Multivariable Analysis ◽

Injection Therapy ◽

Increased Risk ◽

Dieulafoy Lesion

Background and Objective: Dieulafoy lesion is a rare, but life-threatening, cause of gastrointestinal hemorrhage, and endoscopic therapy is the preferred first-line treatment. The present study aims to analyze the risk factors for rebleeding after endoscopic hemostasis of gastroduodenal Dieulafoy lesion. Methods. A retrospective review of patients with Dieulafoy lesion who developed acute gastrointestinal bleeding and were treated primarily with endoscopic therapy from September 2014 to April 2019 was conducted. Results. A total of 133 patients with Dieulafoy lesion were included in the present study. The mean age of these patients was 56.05 ± 16.58 years, and 115 patients were male. Among these 133 patients, 26 patients developed rebleeding within 30 days of endoscopic therapy. The 30-day rebleeding rate for pure injection therapy (epinephrine, cyanoacrylate, or lauromacrogol injection alone), nonpure injection therapy (argon plasma coagulation, band ligation, and hemoclip application alone), and combination therapy (combination of any >2 methods) was 45.2%, 12.8%, and 11%, respectively. In the univariable analysis, endoscopic treatment, prothrombin time, gender, Rockall score, and leukocyte count were the risk factors for rebleeding. In the multivariable analysis, pure injection endoscopic treatment, white blood cells (>10 × 109/L), and prothrombin time >12 seconds were the independent risk factors for rebleeding. Conclusion. Patients who undergo pure injection endoscopic treatment and have a high leukocyte count (>10 × 109/L) or elevated prothrombin time (>12 seconds) have an increased risk of rebleeding within 30 days after endoscopic treatment for gastroduodenal Dieulafoy lesion. Combined endoscopic treatment is the most effective therapy to prevent rebleeding in gastroduodenal Dieulafoy lesion.

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Viability and Distribution of Leukocytes Following Cross-Circulation Experiments Between Leukemic and Normal or Irradiated Rats

Blood ◽

10.1182/blood.v12.2.140.140 ◽

1957 ◽

Vol 12 (2) ◽

pp. 140-146 ◽

Cited By ~ 2

Author(s):

J. W. HOLLINGSWORTH ◽

STUART C. FINCH ◽

MARY CHALTAS

Keyword(s):

Radiation Damage ◽

White Blood Cells ◽

Leukemic Cells ◽

Sprague Dawley ◽

Arterial Blood ◽

Leukocyte Counts ◽

Vascular Channels ◽

Blood Leukocyte ◽

Rat Tail ◽

Tail Blood

Abstract 1. Recipient rats were observed following periods of circulatory mixing with normal or leukemic donor animals. 2. The normal rat tail appears to store leukocytes in its vascular channels, as evidenced by a progressively falling leukocyte count from a tail incision as the tail is "milked." 3. Comparison of irradiated rat tail and arterial blood leukocyte counts during and after cross-circulation revealed the tail values to be consistently higher than the simultaneous arterial levels. This observation excludes a major removal and destructive mechanism by some organ such as the lung as a major cause of the rapid decrease in arterial blood leukocyte levels noted in irradiated rats after the cross-circulation procedure. 4. Tail blood leukocyte counts of irradiated, cross-transfused rats remained higher than those of control irradiated rats for at least three days. 5. After cross-circulation with leukemic donor rats, leukemic cells were identified in the tail blood of normal rats for at least three days. 6. Prolonged observations revealed that 2 irradiated Sprague-Dawley strain recipients of leukemic cells from Sherman strain leukemic donors survived the severe radiation damage but developed leukemia. This observation suggests that transfused leukemic white blood cells protect against radiation damage. 7. Five normal Sherman strain rats developed leukemia after cross-circulation with leukemic Sherman donors. This incidence (50 per cent) of transmission to adult animals is much higher than has been reported by conventional methods of transfer. 8. The observations reported support the concept of viability of leukocytes transfused in rats by this method, and suggest that at least one site of noncirculating transfused leukocytes is within sluggish vascular channels.

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Cecum ligation and dissection: a novel modified mouse sepsis model

Journal of Surgical Research ◽

10.1016/j.jss.2012.11.046 ◽

2013 ◽

Vol 183 (1) ◽

pp. 321-329 ◽

Cited By ~ 5

Author(s):

Haitham Mutlak ◽

Carla Jennewein ◽

Nguyen Tran ◽

Martina Mehring ◽

Kathrina Latsch ◽

...

Keyword(s):

Sepsis Model ◽

Cecum Ligation ◽

Mouse Sepsis Model

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Effect of Different Dialyzer Membranes on Serum Angiotensin-Converting Enzyme during Hemodialysis

The International Journal of Artificial Organs ◽

10.1177/039139888801100107 ◽

1988 ◽

Vol 11 (1) ◽

pp. 28-32 ◽

Cited By ~ 4

Author(s):

D. Docci ◽

C. Delvecchio ◽

F. Turci ◽

L Baldrati ◽

C. Gollini

Keyword(s):

Angiotensin Converting Enzyme ◽

Vascular Endothelium ◽

Blood Cells ◽

Serum Proteins ◽

Leukocyte Count ◽

White Blood Cells ◽

Converting Enzyme ◽

Serum Angiotensin Converting Enzyme ◽

Pulmonary Vascular Endothelium ◽

The Mean

The effects of different dialyzer membranes on serum concentration of angiotensin-converting enzyme (ACE) and white blood cells during hemodialysis were examined on a cross-over basis in 20 chronically uremic patients. Hemodialysis with cuprophane membranes was associated with a significant (p < 0.001) fall in the mean leukocyte count during the 1st hour of treatment. The use of polymethylmetacrylate membranes resulted in a more attenuated form of leukopenia and with polyacrylonitrile membranes no change was observed during hemodialysis. Hemodialysis with each membrane caused a comparable, significant (p < 0.005) increase in serum ACE, independent of the degree of leukopenia but significantly (p < 0.001) correlated with the increases in serum proteins. We conclude that this increase in serum ACE concentration after hemodialysis does not reflect acute damage of the pulmonary vascular endothelium during treatment and most probably is a result of hemoconcentration. Therefore, serum ACE analysis is not an indicator of dialyzer membrane biocompatibility.

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Transient leukocytosis in Emergency Room: an overlooked issue

Italian Journal of Medicine ◽

10.4081/itjm.2017.724 ◽

2017 ◽

Vol 11 (1) ◽

pp. 41

Author(s):

Giampiera Bertolino ◽

Federica Quaglia ◽

Luigia Scudeller ◽

Iride Ceresa ◽

Carlo L. Balduini

Keyword(s):

Differential Diagnosis ◽

Emergency Room ◽

Blood Cells ◽

Leukocyte Count ◽

White Blood Cells ◽

C Reactive Protein ◽

Reactive Protein ◽

Reliable Marker ◽

Wbc Count ◽

Clinical Records

Leukocytosis is regarded as a reliable marker of a serious disorder requiring hospitalization. However, leukocytosis often disappears once the patient is admitted to a medical ward; differential diagnosis of leukocytosis is often overlooked in the busy Emergency Room (ER) routine. We retrospectively evaluated the clinical records of 565 consecutive patients admitted to the Department of Internal Medicine (DIM) after examination in ER. Mean leukocyte count was 11.4×109/L in ER and 10.1×109/L in DIM (P<0.001). Leukocytosis was found in 53.1% of patients in ER, but in 33% of these it was no longer evident on the following day, unrelated to baseline white blood cells (WBC) count, age, sex, diagnosis, C-reactive protein level and early antibiotic treatment. A reduction in WBC count larger than 40% from baseline occurred in 13.6% of all subjects, and in 31.7% of those with transient leukocytosis. Leukocytosis in ER is frequent, but it is often transient and not associated with an infectious cause. Other causes, including psychological stress caused by the ER access itself, should be considered in the differential diagnosis.

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Ivabradine Attenuates the Microcirculatory Derangements Evoked by Experimental Sepsis

Anesthesiology ◽

10.1097/aln.0000000000001431 ◽

2017 ◽

Vol 126 (1) ◽

pp. 140-149 ◽

Cited By ~ 10

Author(s):

Marcos L. Miranda ◽

Michelle M. Balarini ◽

Daniela S. Balthazar ◽

Lorena S. Paes ◽

Maria-Carolina S. Santos ◽

...

Keyword(s):

Cell Function ◽

Blood Gases ◽

Tissue Perfusion ◽

Capillary Density ◽

Abdominal Sepsis ◽

Experimental Sepsis ◽

Endothelial Cell Function ◽

Beneficial Effects ◽

Arterial Blood ◽

Baseline Values

Abstract Background Experimental data suggest that ivabradine, an inhibitor of the pacemaker current in sinoatrial node, exerts beneficial effects on endothelial cell function, but it is unclear if this drug could prevent microcirculatory dysfunction in septic subjects, improving tissue perfusion and reducing organ failure. Therefore, this study was designed to characterize the microcirculatory effects of ivabradine on a murine model of abdominal sepsis using intravital videomicroscopy. Methods Twenty-eight golden Syrian hamsters were allocated in four groups: sham-operated animals, nontreated septic animals, septic animals treated with saline, and septic animals treated with ivabradine (2.0 mg/kg intravenous bolus + 0.5 mg · kg−1 · h−1). The primary endpoint was the effect of ivabradine on the microcirculation of skinfold chamber preparations, assessed by changes in microvascular reactivity and rheologic variables, and the secondary endpoint was its effects on organ function, evaluated by differences in arterial blood pressure, motor activity score, arterial blood gases, and hematologic and biochemical parameters among groups. Results Compared with septic animals treated with saline, those treated with ivabradine had greater functional capillary density (90 ± 4% of baseline values vs. 71 ± 16%; P < 0.001), erythrocyte velocity in capillaries (87 ± 11% of baseline values vs. 62 ± 14%; P < 0.001), and arteriolar diameter (99 ± 4% of baseline values vs. 91 ± 7%; P = 0.041) at the end of the experiment. Besides that, ivabradine-treated animals had less renal, hepatic, and neurologic dysfunction. Conclusions Ivabradine was effective in reducing microvascular derangements evoked by experimental sepsis, which was accompanied by less organ dysfunction. These results suggest that ivabradine yields beneficial effects on the microcirculation of septic animals.

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Effects of biocompatible extracorporeal bypass circuit coating Bioline in cardiac surgery patients

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2013-2-51-56 ◽

2015 ◽

Vol 17 (2) ◽

pp. 51 ◽

Cited By ~ 1

Author(s):

I. V. Ponomarenko ◽

V. M. Shipulin ◽

O. N. Ogurkova ◽

T. Ye. Suslova

Keyword(s):

Cardiac Surgery ◽

Interleukin 6 ◽

Leukocyte Count ◽

Assisted Ventilation ◽

Arterial Blood ◽

Before And After ◽

Transfusion Volume ◽

Extracorporeal Circuits ◽

Extracorporeal Bypass ◽

Necrosis Factor

Biocompatibility of heparin-based coating for extracorporeal circuits, the Bioline, was evaluated in cardiac surgery setting. Thirty six CABG pts, aged from 30 to 69 yrs, were randomly perfused with a circuit containing Bioline-coated Quadrox oxygenator (Bioline, n=18) or with a similar non-coated circuit (control, n=18). Leukocyte and platelet counts, levels of tumor necrosis factor, interleukin-6 and fibrinogen were assessed in arterial blood before, during and after cardiopulmonary bypass (CPB). Oxygenation and ventilation indices before and after surgery, post-operative chest tube drainage and transfusion volume as well as the duration of assisted ventilation were also measured. A platelet count and fibrinogen dropped less in the Bioline group significantly compared with that in control at the end of CPB (p<0,05) and after protamine administration (p<0,05). A leukocyte count and an interleukin-6 level increased more in controls after CPB (p<0,05) as well as oxygenation and ventilation indices, bleeding volume and intubation time (all p<0,05). Our results suggest surface heparinization with Bioline coating limited to the oxygenator ameliorates the inflammatory response, preserves fibrinogen and platelets, reduces blood loss postoperatively and improves lung function during CPB.

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Is subdiaphragmatic aortic cross-clamping a suitable model for spinal cord ischemia/reperfusion injury study in rats?

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502006000400006 ◽

2006 ◽

Vol 21 (4) ◽

pp. 219-222 ◽

Cited By ~ 1

Author(s):

Sonia Elizabeth Lopez Carrillo ◽

Sérgio Botelho Guimarães ◽

Paulo Roberto Cavalcante de Vasconcelos ◽

Paulo Roberto Leitão de Vasconcelos

Keyword(s):

Spinal Cord ◽

Reperfusion Injury ◽

Ischemia Reperfusion Injury ◽

Ischemia Reperfusion ◽

Spinal Cord Ischemia ◽

Albino Rats ◽

Surgical Trauma ◽

Suitable Model ◽

Arterial Blood ◽

Tissue Metabolites

PURPOSE: To evaluate the efficacy of subdiaphragmatic aortic cross-clamping in an experimental model of ischemia/reperfusion injury of the spinal cord in albino rats. METHODS: Thirty-six male Wistar rats were randomized in two groups (n=18): G-1 (Sham) and G-2 (Ischemia/Reperfusion, I/R). G-2 rats were submitted to 30 min subdiafragmatic aortic cross-clamping. G-1 rats served as controls and were submitted to surgical trauma (laparotomy) without ischemia. Samples (spinal cord and arterial blood) were collected at the end of ischemic period and 10 (T-10) and 20 (T-20) min later in G-2 rats. Sham rats (G-1) samples were collected at the same time-points. Blood and tissue metabolites concentrations of pyruvate, lactate, glucose and medullary adenosine triphosphate (ATP) were assayed. RESULTS: Blood and tissue concentrations of pyruvate and glucose as well as lactate and medullary ATP were not different when comparing G1 to G2. Lactacemia was significantly elevated in G-2 compared with G-1 rats during reperfusion (T-10). CONCLUSION: Subdiaphragmatic aortic cord cross-clamping is not a suitable rat model for spinal cord ischemia/reperfusion injury study as it does not ensure changes in in vivo tissue metabolites concentrations similar to those found in tissues subjected to ischemia/reperfusion.

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