Varga Adam, Matrai Adam Attila, Bedocs-Barath Barbara, Fazekas Laszlo Adam, Brasil Felipe Salignac, Mehta Aashna, Vanyolos Erzsebet, Deak Adam, Lesznyak Tamas, Peto Katalin, Nemeth Norbert
Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Moricz Zsigmond u. 22, H-4032 Debrecen, Hungary.
Metabolites. 2024 Aug 18;14(8):458. doi: 10.3390/metabo14080458.
Hemorheological factors may show arterio-venous differences. Alterations in acid-base and metabolic parameters may also influence these factors. However, little is known about changes in micro-rheological parameters during abdominal surgery, influencing splanchnic circulation. In anesthetized pigs, the external jugular vein, femoral artery and vein were cannulated unilaterally, and paramedian laparotomy was performed. In the anastomosis group, after resecting a bowel segment, end-to-end jejuno-jejunostomy was completed. Blood samples (from cannulas and by puncturing the portal vein) were taken before and after the intervention. Hematological, acid-base and blood gas parameters, metabolites, red blood cell (RBC) deformability and aggregation were determined. The highest hematocrit was found in portal blood, increasing further by the end of operation. A significant pH decrease was seen, and portal blood showed the highest lactate and creatinine concentration. The highest RBC aggregation values were found in arterial, the lowest in renal venous blood. The RBC aggregation increased with higher lactate concentration and lower pH. Osmotic gradient deformability declined, with the lowest values in portal and renal venous samples. In conclusion, micro-rheological parameters showed arterio-venous and porto-renal venous differences, influenced by oxygenation level, pH and lactate concentration. The intestinal anastomosis operation caused an immediate micro-rheological deterioration with portal venous dominancy in this experiment.
血液流变学因素可能存在动静脉差异。酸碱和代谢参数的改变也可能影响这些因素。然而，关于腹部手术期间影响内脏循环的微观流变学参数变化，人们了解甚少。在麻醉的猪身上，单侧插入颈外静脉、股动脉和股静脉，并进行旁正中剖腹术。在吻合组中，切除一段肠段后，完成端端空肠吻合术。在干预前后采集血样（从插管处以及通过穿刺门静脉采集）。测定血液学、酸碱和血气参数、代谢产物、红细胞（RBC）变形性和聚集性。门静脉血中血细胞比容最高，在手术结束时进一步升高。观察到pH值显著下降，门静脉血中乳酸和肌酐浓度最高。动脉血中红细胞聚集值最高，肾静脉血中最低。红细胞聚集随着乳酸浓度升高和pH值降低而增加。渗透梯度变形性下降，门静脉和肾静脉样本中的值最低。总之，微观流变学参数存在动静脉以及门静脉与肾静脉差异，受氧合水平、pH值和乳酸浓度影响。在本实验中，肠道吻合手术导致微观流变学立即恶化，门静脉占主导地位。
