Gosche J R, Garrison R N, Harris P D, Cryer H G
Department of Surgery, University of Louisville School of Medicine, KY 40292.
Arch Surg. 1990 Dec;125(12):1573-6. doi: 10.1001/archsurg.1990.01410240055012.
Enteral nutritional support has been found to result in better maintenance of mucosal integrity during stress than parenterally administered nutritional support. In our experiments, we employed in vivo microvascular techniques to examine the effect of mucosally applied glucose on intestinal microvascular blood flow during hyperdynamic live Escherichia coli bacteremia in the rat. We observed a significant decrease in intestinal microvascular blood flow during bacteremia when the mucosa was suffused with a nonglucose solution. Blood flow was rapidly restored to above-baseline values after glucose was added. The restoration of blood flow resulted from dilation of arterioles at all branch orders and was associated with dilation of premucosal arterioles to above-baseline diameters. Our results show that glucose-induced absorptive hyperemia restores intestinal blood flow during live E coli bacteremia. Restoration of intestinal microvascular blood flow may be a contributing factor to the improved maintenance of mucosal integrity associated with enteral feeding.
已发现肠内营养支持在应激期间比胃肠外营养支持能更好地维持黏膜完整性。在我们的实验中,我们采用体内微血管技术来研究在大鼠高动力性活大肠杆菌菌血症期间,黏膜应用葡萄糖对肠道微血管血流的影响。我们观察到,当黏膜用非葡萄糖溶液灌注时,菌血症期间肠道微血管血流显著减少。添加葡萄糖后,血流迅速恢复到基线以上水平。血流的恢复是由于各级分支小动脉的扩张,并且与黏膜前小动脉扩张至基线以上直径有关。我们的结果表明,葡萄糖诱导的吸收性充血可在活大肠杆菌菌血症期间恢复肠道血流。肠道微血管血流的恢复可能是肠内喂养相关的黏膜完整性维持改善的一个促成因素。