Frieling Helge, Lauer Kai-Steffen, Gründling Matthias, Usichenko Taras, Meissner Konrad, Kanellopoulou Theoni, Lehmann Christian, Wendt Michael, Pavlovic Dragan
Klinik und Poliklinik für Anästhesiologie und Intensivmedizin, Ernst Moritz Arndt University, Friedrich-Loeffler Str. 23B, 17487, Greifswald, Germany.
Int J Colorectal Dis. 2007 Jul;22(7):807-17. doi: 10.1007/s00384-006-0239-x. Epub 2006 Nov 21.
Treatment of peritonitis may include peritoneal lavage/instillation with anti-infective agents like taurolidine or chlorhexidine.
We examined the effects of peritoneal instillation (INST, 5-ml solution) with taurolidine (TAURO) or polihexanide (POLI-LS) on intestinal microcirculation using intravital microscopy (IVM) in experimental endotoxemia (15 mg/kg lipopolysaccharide i.v.; LPS) in the rat (n = 8 each group), their direct effects on local small blood vessels, aortal rings, and myocardial strips in vitro, as well as plasma interleukin levels.
It was found that LPS produced hypotension (98.8 +/- 9.5 vs 130.4 +/- 10.5 mmHg; mean arterial pressure [MAP], mean +/- standard deviation [SD]), which was further pronounced after INST of TAURO (78.8 +/- 10.8; P < 0.005) or POLI-LS (78.1 +/- 6.0; P < 0.001). IVM revealed a reduction in temporary adhering leucocytes and an increase in firmly adhering leucocytes after INST with TAURO and POLI-LS. Both agents reduced functional capillary density either in the mucosa (POLI-LS vs sham: 259.7 +/- 54 cm/cm(2) vs 337.1 +/- 35.5) or longitudinal muscular layer in LPS rats (TAURO vs sham: 119.8 +/- 14.8 vs 153.7 +/- 11.0). POLI-LS induced local vasodilatation, whereas TAURO induced small vasoconstriction; in vitro, both agents showed vasodilating properties and did not have any effect on myocardial strip contraction.
Some of the observed microcirculatory changes could be a result of the direct vascular effects of these agents.
