Resuscitation with hydroxyethyl starch 130/0.4 attenuates intestinal injury in a rabbit model of sepsis

Abstract

Objective: Improvement of mucosal barrier function and reduction of bacterial translocation are important in the management of sepsis. The mechanisms that underlie the protective effects of colloids on the intestinal mucosal barrier are unclear. The study aims to investigate the effect of fluid resuscitation with hydroxyethyl starch (HES) 130/0.4 against intestinal mucosal barrier dysfunction in a rabbit model of sepsis.

Materials and methods: Thirty healthy rabbits were randomly and equally divided into a sham-operated control, a sepsis model, or a sepsis + HES treatment group. The sepsis model and sepsis + HES treatment groups were subjected to a modified colon ascendens stent peritonitis (CASP) procedure to induce sepsis. Four hours after the CASP procedure, fluid resuscitation was performed with 6% HES 130/0.4. Arterial and superior mesenteric vein blood samples were collected 4 and 8 h after the CASP procedure for blood gas analysis and measuring tumor necrosis factor-α, interleukin-10, and D-lactate levels. The rabbits were euthanized 8 h after CASP, and sections of the small intestine were stained to evaluate histopathological changes.

Results: Respiratory rate and blood pressure were stable during the resuscitation period. Fluid resuscitation with 6% HES 130/0.4 alleviated pathological changes in the abdominal cavity, improved blood gas parameters and inflammatory mediator levels, decreased plasma D-lactate levels, and reduced intestinal mucosal injury compared with the non-treated sepsis model.

Conclusions: Fluid resuscitation with 6% HES 130/0.4 protects against intestinal mucosal barrier dysfunction in rabbits with sepsis, possibly via mechanisms associated with improving intestinal oxygen metabolism and reducing the release of inflammatory mediators.

Keywords: HES 130/0.4; inflammatory mediators; intestinal mucosal barrier; resuscitation; sepsis.

Figure 1

Dynamic changes in (a) MAP and (b) heart rate (n = 10). Data shown are mean ± standard deviation. *P < 0.05 compared with 4 h

Figure 2

Changes in plasma levels of (a) TNF-β and (b) IL-10 at 4 and 8 h after induction of sepsis among the different groups (n = 10). *P < 0.05 compared with the sham-operated control group; #P < 0.05 compared with the sepsis + HES treatment group

Figure 3

Histopathological changes in the small intestinal mucosa of rats of different groups 8 h after induction of sepsis. (a) sepsis model; (b) sepsis + HES treatment; C, sham-operated control (H and E, ×100 staining)