• Roberto Rasslan, Edivaldo Massazo Utiyama, Geraldo Magela Nogueira Marques, Thiago Camargo Ferreira, Vitor Alves Pessoa da Costa, Nathalia Cruz de Victo, Samir Rasslan, and Edna Frassonde Souza Montero.
• Department of Surgery, Surgical Physiopathology Laboratory (LIM-62), School of Medicine, University of São Paulo, Brazil.
• Int J Surg. 2014 Jan 1;12(6):594-600.

BackgroundIntestinal obstruction is an abdominal disease associated to mortality, especially if complicated with sepsis. Resuscitation increases survival, although controversies remain concerning to therapeutic strategy.MethodsTo assess the effects of hypertonic saline and pentoxifylline on the inflammatory response and oxidative stress, Wistar rats underwent a laparotomy loop intestinal obstruction and ischemia. After 24 h, the intestinal segment was resected (IO) without any other treatment and resuscitation/pentoxifylline were administered according to the group: Ringer's lactate (RL); hypertonic saline (HS); pentoxifylline (PTX); Ringer's lactate with pentoxifylline (RL + PTX); hypertonic saline with pentoxifylline (HS + PTX) and the control group (CG) that was not submitted to ischemia and obstruction. Mean arterial pressure (MAP) was recorded 4 times, and euthanasia was done 3 h after the resuscitation to obtain lung tissue, for malondialdehyde (MDA) by thiobarbituric acid reactive substances (TBARS) method, inflammatory cytokines were assessed using ELISA and NF-κΒ by Western blotting.ResultsThe initial MAP levels were higher in the RL and HS groups than in the others; however, the last measurement was similar among all the groups. IL-1β, IL-6 and CINC-1 (Cytokine-Induced Neutrophil Chemoattractant-1) were lower in the HS, PTX and HS + PTX groups compared with the IO and RL groups. IL-10 was lower in the HS + PTX group than in the IO group. NF-κB in the HS, PTX and HS + PTX groups were lower than in the IO group; NF-κB in the HS + PTX group was lower than in the RL group. MDA in the lung was lower in the HS + PTX group compared with other groups.ConclusionHypertonic saline and pentoxifylline, both alone and in combination, attenuated oxidative stress and the activation of NF-κB, leading to a decrease in the inflammatory response.Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

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