Effect Of Intraoperative Fluid Management On Intestinal Ischemia-reperfusion Injury In The Rabbit

Purpose:Fluid management plays a significant status in anesthesia intraoperative administration. To inquired whether Restrictive Fluid is the protective effect to small intestine after intestinal ischemia reperfusion injury (IRI). Further, to research and investigate the mechanism of it, and to provide an experimental basis for the scientific and rational fluid therapy program in the perioperative.Methods:Seventy male rabbits were randomly allocated into the three groups:(i) normal group (Normal, n=10), in which directly executed without any intervention;(ii) intestinal IRI restrictive fluid group (RFQ n=30,8ml·kg-1·-1, intravenous), which was injected Lactated Ringer’s solution. Animals were subjected to occlude60min superior mesenteric artery (SMA) and follow by120min reperfusion. At24h,48h and72h postoperative separately killed rabbits (n=10, every time);(ⅲ) intestinal IRI liberal fluid group (LFQ n=30,14ml-kg-1-h-1, intravenous),only amounts of fluid is distinguish from restrictive fluid group, other intervening measure as the same as the previous group. To detected serum endotoxin level by collecting portal vein’s blood, and cut out intestine to observe intestinal mucosa histology change and apoptosis.Results:Intestinal mucosa histology damage and cell apoptosis in the RFG was slighter than the LFG Compare with the LFG, restrictive fluid treatment also significantly lessened levels of serum endotoxin, increased expression of Bcl-2mRNA yet reduction Bax, consequently, advanced Bcl-2/Bax ratio.(Bcl-2family is one of the genes of current concern and closely related with apoptosis, Bcl-2and Bax are homology genes and a couple of promote apoptosis gene. Bcl-2could inhibition of apoptosis and prolong cell survival, which is an anti-apoptotic genes. Bax is a typical pro-apoptotic gene and has the opposite role with Bcl-2. The ratio of Bcl-2/Bax becomes an important factor affect the cell survival.) However, in the LFG,interesting phenomenon had been found is that both serum endotoxin level and mRNA expression of Bax reach the peak in48h this time interval,then falling down at the time of72h.Conclusion:These outcomes demonstrate that intraoperative restrictive fluid is a protective effect when intestinal ischemia reperfusion injury happened in animal model, which may be owed to restrictive fluid reducing the damage of intestinal mucosa and inhibiting intestinal cell apoptosis.