European surgical research. Europäische chirurgische Forschung. Recherches chirurgicales européennes
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Bacteria transfer to the blood from the peritoneum is thought to be augmented when the diaphragmatic stomata are activated by an increased intra-abdominal pressure. Therefore, it may be expected that the increase in intra-abdominal pressure during laparoscopic surgery can augment the absorption of bacteria from the peritoneum to the blood. The present study examines the effect of pneumoperitoneum on bacteremia in experimental Escherichia coli peritonitis in rabbits. ⋯ In all groups, the growth value (GV) was measured in the 3rd- and 6th-hour blood cultures using the Bactec NR 730 system. There was no difference in the 3rd- and 6th-hour GVs (p > 0.05) among the three groups. In conclusion, pneumoperitoneum with 15 mm Hg CO2 in experimental E. coli peritonitis did not increase the bacteremia when compared with the control and laparotomy groups.
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Tissue oxygenation depends on the volume of oxygen consumed by the tissue and the volume of oxygen supply. This is particularly important in the liver after ischaemia and reperfusion, due to the relatively low oxygen saturation of the portal blood flow, the main source of oxygen to the liver. ⋯ Changes were found in the postischaemic liver blood flow and haemoglobin saturation in all the groups when compared to control values, showing a correlation between the length of the period of ischaemia and the magnitude of the alteration in the reperfusion blood flow and oxygenation. These alterations may be considered as a prolongation of the metabolic condition of ischaemia and may be part of an additional tissue damage upon reperfusion.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of dextran and crystalloids on subcutaneous oxygen tension and collagen accumulation. A randomized study in surgical patients.
Twenty-nine patients, subjected to major abdominal surgery, were randomized to different types of postoperative fluid replacement, given on the basis of subcutaneous oxygen tension measurements (PscO2). One regimen consisted of crystalloids, the other of a combination of crystalloids and colloids (dextran 70). Perioperative fluid replacement was given according to clinical criteria and postoperatively according to polarographic PscO2 measurements. ⋯ They were removed on day 5 and 7, and analysed for hydroxyproline content. Total postoperative fluid support was equal in the two groups, and so was the hydroxyproline content on day 7. In conclusion, postoperative fluid substitution with dextran has no advantages over crystalloids only, with regard to granulation tissue formation if postoperative fluid support is optimum, according to PscO2 measurements.
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Comparative Study
PGI2 aerosol versus nitric oxide for selective pulmonary vasodilation in hypoxic pulmonary vasoconstriction.
Intravenous prostacyclin (PGI2) is a potent pulmonary vasodilator in pulmonary hypertension. However, dose-dependent systemic vasodilation, an increase in intrapulmonary shunt and hypoxemia limit its clinical application. Recently, inhaled nitric oxide (NO) has been reported to elicit selective pulmonary vasodilation, but its clinical use is restricted by its potential toxicity; furthermore, the feasibility of NO application in clinical practice seems difficult. ⋯ It is concluded that inhalation of aerosolized PGI2 leads to selective pulmonary vasodilation in hypoxia-induced pulmonary hypertension. Aerosolized PGI2 at a concentration of 430 ng/ml was less potent than NO (50 ppm). However, due to the lack of known toxicity and its uncomplicated mode of application, inhaled PGI2 may be one alternative to inhaled NO in the treatment of acute pulmonary hypertension.
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Anatomical features of the oral fissure and pharynx of rabbits make orotracheal intubation a difficult task with a high failure rate. We have developed a versatile technique for retrograde intubation of rabbits which consists of the following steps: (1) assessment of the trachea through a cervicotomy (2) insertion of a guidewire into its lumen, (3) delivery of the guide through the mouth, and (4) introduction of the orotracheal tube over the guide. ⋯ No complications related to this technique were observed during a follow-up period of 5-14 days. The described technique is a simple and safe method to access the airways of rabbits and can be useful in chronic experiments.