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The exclusion of the mesenteric lymph during a bacterial translocation process substantially diminishes the microcirculation injuries

Introduction

Bacterial translocation (BT) has been attributed as the causal hypothesis in the development of the multi-organ failure syndrome induced by sepsis, which has been known as 'the gut hypothesis of sepsis'. Such a process is believed to occur by lymphatic and/or hematological routes. In this study we evaluated the role of the lymphatic route in the genesis of microcirculation injury.

Methods

Adult female Wistar rats (200–250 g) underwent BT induction (BT), and BT induction 5 days (BT5) and 30 days (BT30) post-mesenteric lymphadenectomy, which provoked a complete obstruction of efferent mesenteric lymph flow and re-canalization of the lymph duct, respectively. In the other group, following 30 days post-lymphadenectomy, animals were submitted to the same BT process with exclusion of the efferent lymph duct performed by catheterization (BT30E) (n = 5/group). In these conditions, all animals were submitted to mesenteric microcirculation study by an intravital microscope method from 2 hours of BT up to 4 hours.

Results

Animals submitted to BT showed significant injuries. Always, the first lesion was leukocyte adhesion followed by capillary and small venula obstructions and hemorrhage of low flow capillaries and venules 2 hours following the BT process. The BT5 group showed only leukocyte adhesion and the BT30E group showed similar lesions as BT-group alterations, although were much milder even after 4 hours of the BT process. The lesions in the BT30 group initiated around 3 hours of the BT process, basically with leukocyte adhesion followed by few capillary obstructions and rare hemorrhages.

Conclusion

This study demonstrates that the lymphatic route might carry factor(s) related to the microcirculation injuries induced by gut-associated lymphoid tissue during the BT process.

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Vilela-Oliveira, L., Silva, R., Menchaca-Diaz, J. et al. The exclusion of the mesenteric lymph during a bacterial translocation process substantially diminishes the microcirculation injuries. Crit Care 9 (Suppl 2), P52 (2005). https://doi.org/10.1186/cc3596

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  • DOI: https://doi.org/10.1186/cc3596

Keywords

  • Leukocyte Adhesion
  • Bacterial Translocation
  • Lymph Flow
  • Flow Capillary
  • Intravital Microscope