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Einfluss von Anästhetika auf die intestinale und hepatische Sauerstoffversorgung und Mikrozirkulation in der Sepsis

Erscheinungsjahr: 2023
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ISBN/EAN: 9783835970915
Sprache: Deutsch
Umfang: 170
Format (T/L/B): 21.0 x 14.0 cm

Beschreibung

Microcirculatory oxygen supply (µHbO2) of the intestine and the liver plays an important role in development and outcome of sepsis. The aim of this study was to find out, whether and to what extent different anesthetics affect the oxygenation of the gastrointestinal tract and the liver in a septic rat model. Therefore, 120 animals were randomized into two groups: the non-septic (sham-operated) group, and the septic (CASP-operated) group. Sham and CASP animals were further randomly related to 5 groups depending of the applied anesthetics (n=12 per group). CASP and Sham operation were performed under intravenous anesthesia with Pentobarbital. 24 hours later, the animals were anesthetized again with one of five different study anesthetics (Sevoflurane, Isoflurane, Propofol, Midazolam or Dexmedetomidine) and ventilated for the duration of the experiment. Systemic (MAP, HR) and microcirculatory (µHbO2) parameters were assessed over the entire test period. The microcirculatory oxygen supply (µHbO2) of the intestine and the liver was the focus of this study. In the sham- as well as in the CASP-operated animals all anesthetics resulted in a significant impairment of the macrocirculatory parameters and consequently in the deteriorated microcirculation of the colon. The colonic µHbO2 did not deteriorate further in the course of the experiment. No significant differences were observed between the study groups. None of the used anesthetics affected the microcirculation of the liver independent of the study conditions (septic or non-septic) The main conclusion of this study is that neither under septic condition, nor after laparotomy, the applied anesthetics affected the microcirculation of the liver, while all the drugs impaired the colonic microcirculation. A negative effect of all investigated anesthetics on the macrohemodynamic parameters (HR, MAP) can be presumed as a reason for the impaired intestinal microcirculation. The organ-specific differences could be explained by the superior blood supply and pronounced compensation mechanisms in case of impaired oxygen supply in the liver compared to those of the intestine.

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