Does metoclopramide prevent bacterial translocation (BT)?

Full text

One of the mechanisms causing BT is impaired host defense. Metoclopramide (M) restores the depressed immune function after hemorrhage [1]. To our knowledge, there is no study investigating the effect of M on BT.

Procedures

We investigated the administration of M on BT in a dog model of ischemia-reperfusion (IR) injury induced by thoracic aortic cross-clamping and declamping. Twenty-two mongrel dogs were randomized into three groups: sham-operated group (n=7) (without cross-clamping), M group (n=8) and placebo group (n=7). Placebo and M group received placebo and M (0.15 mg/kg iv), respectively, before cross-clamping. During 45 min of ischemia and 30 min reperfusion arterial blood gases and hemodynamic data were continuously recorded. 72 h later dogs were re-operated on, and peritoneal swabs, blood samples and specimens from duodenum, jejunum, ileum, colon, mesenteric lymph node (MNL), heart, spleen, kidney, liver and lung were obtained for bacteriological analysis. Blood samples were also obtained before the first operation.

Results

No dogs in the sham group showed BT. Two ischemia-reperfusion groups were found to have BT in various organs; however, M prevented BT to the MLN (χ²) without producing any hemodynamic changes (Mann-Whitney U-test, Kruskal Wallis one way ANOVA, Friedman two way ANOVA) organs (χ²). Both gram (-) and gram (+) microorganisms translocated. One dog in the placebo group and two dogs in M group developed bacteremia after the first operation.

Conclusion

M prevents BT to the MLN. Whether higher doses of M prevent BT and the clinical importance of these results requires further studies.