To study the effects of early enteral nutrition and selective decontamination of digestive tract on the lipopolysacchride (LPS) translocation and cytokines and the developing of multiple organ dysfunction syndrome (MODS). Thirty six rabbits were divided into 3 groups: ①control group (CON group, n＝12), the rabbits were bled to shock state (MAP was 5.33 kPa) for 1 hour and then were resuscitated by with replacement of the lost blood and 2 volume of the equilibrium liquid, ②selective decontamination of digestive tract (SDD group, n＝12), the procedure was the same as the CON group but the rabbit was fed with the antibiotics 3 days before the experiment and all through the experiment, ③early enteral nutrition group (EN group, n＝12), treatment was the same as CON group. After resuscitation the feeding tube was placed into the stomach for enteral nutrition. On the 1st, 3rd, 5th and 7th day the blood samples were taken for testing the LPS, TNFα and the organs’ function. Results: The MODS incidence, the levels of LPS and TNFα of the EN group were obviously lower than those in SDD and CON groups; the levels of the LPS and TNFα of the SDD group remained high in the 5th day. SDD group had a higher incidence of the MODS and mortality than that of the EN group. Conclusion: Ischemiareperfusion damage can produce the LPS translocation, which causes the development of MODS. SDD can’t decrease the LPS translocation so that the incidence of MODS and mortality remain high. Early EN can inhibit LPS translocation and reduce the development of MODS.
Citation：
Kang Yan,Mao Haixiang,Xiong Xianze,et al.. THE EFFECTS OF EARLY ENTERAL NUTRITION ON THE LIPOPOLYSACCHRIDE AND CYTOKINES. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 1999, 6(2): 70-72. doi:
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- 1. Dorindky PM, Gaded JE. Multiple organ failure. Clin Chest Med, 1990; 11(4)∶581.
- 2. Carrier. Multiple organ failure syndrome. Arch Surg, 1986; 121(2)∶196.
- 3. Manson WJ, Dijkema H, Klasen HJ. Alteration of wound colonization by selective intestinal decontamination in thermally injured mice. Burns, 1990; 16(3)∶166.
- 4. 胡森， 盛志勇， 薛丽波等. 创伤后多系统器官衰竭(MSOF)动物模型的实验研究. 中华整形烧伤外科杂志， 1992； 8(1)∶2.
- 5. Saba TM. RES systemic host defense after surgery and traumatic shock. Circ Shock, 1975; 2(1)∶91.
- 6. Tracey KJ, Fong Y, Hesse DG, et al. Anticachectin/TNF monoclonal antibodies prevent septic shock during lethal bacteremia. Nature, 1987; 330(6149)∶772.
- 7. Van Leeuwwen PAM, Hong RW, Rounds JD, et al. Hepatic failure and coma after liver resection is reversed by manipulation of gut contents: the role of endotoxin. Surgery, 1991; 110(2)∶169.
- 8. Coalson JJ, Benjamin B, Archer LT, et al. Prolonged shock in the baboon subjected to infusion of E coli endotoxin. Circ Shock, 1978; 5(4)∶423.
- 9. Nevola JS, Stocker BAD, Laux DC, et al. Colonization of the mouse intestine by an avirulent salmonella typhymurium strain and its lipopolysacchridedefective mutants. Infect Immun, 1985; 50(1)∶152.
- 10. Lehmann V, Freudenberg MA, Galanos C. Lethal toxicity of lipopolysacchride and tumor necrosis factor in normal and Dgalactosamine treated mice. J Exp Med, 1987; 165(3)∶657.
- 11. Stoutenbeek CP. Infection prevention in intensive care by selective decontamination of the digestive tract. J Crit Care, 1990; 5(2)∶137.
- 12. Deitch EA, Hempa AC, Specian RD, et al. A study of the relationships among survival, gut origin, sepsis and bacterial translocation in a model of systemic inflammation. J Trauma, 1992; 32(2)∶141.
- 13. Saito H, Trocki O, Alexander JW. The effect of route of nutrient administration on the nutritional state, catabolic hormone secretion and gutmucosal integrity after burn injury. JPEN, 1987; 11(1)∶1.
- 14. Alverdy J, Sang Chi H, Sheldon GF. The effect of parenteral nutrition on gastrointestinal immunity, the importance of enteral stimulation. Ann Surg, 1985; 202(6)∶681.
