New Insight in Loss of Gut Barrier during Major Non-Abdominal Surgery.
<h4>Background</h4>Gut barrier loss has been implicated as a critical event in the occurrence of postoperative complications. We aimed to study the development of gut barrier loss in patients undergoing major non-abdominal surgery.<h4>Methodology/principal findings</h4>Twenty...
Guardado en:
| Autores principales: | , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Public Library of Science (PLoS)
2008
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/c51b68d9140840a7859783612d380d1a |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:c51b68d9140840a7859783612d380d1a |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:c51b68d9140840a7859783612d380d1a2021-11-25T06:18:09ZNew Insight in Loss of Gut Barrier during Major Non-Abdominal Surgery.1932-620310.1371/journal.pone.0003954https://doaj.org/article/c51b68d9140840a7859783612d380d1a2008-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19088854/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Gut barrier loss has been implicated as a critical event in the occurrence of postoperative complications. We aimed to study the development of gut barrier loss in patients undergoing major non-abdominal surgery.<h4>Methodology/principal findings</h4>Twenty consecutive children undergoing spinal fusion surgery were included. This kind of surgery is characterized by long operation time, significant blood loss, prolonged systemic hypotension, without directly leading to compromise of the intestines by intestinal manipulation or use of extracorporeal circulation. Blood was collected preoperatively, every two hours during surgery and 2, 4, 15 and 24 hours postoperatively. Gut mucosal barrier was assessed by plasma markers for enterocyte damage (I-FABP, I-BABP) and urinary presence of tight junction protein claudin-3. Intestinal mucosal perfusion was measured by gastric tonometry (P(r)CO2, P(r-a)CO2-gap). Plasma concentration of I-FABP, I-BABP and urinary expression of claudin-3 increased rapidly and significantly after the onset of surgery in most children. Postoperatively, all markers decreased promptly towards baseline values together with normalisation of MAP. Plasma levels of I-FABP, I-BABP were significantly negatively correlated with MAP at (1/2) hour before blood sampling (-0.726 (p<0.001), -0.483 (P<0.001), respectively). Furthermore, circulating I-FABP correlated with gastric mucosal P(r)CO2, P(r-a)CO2-gap measured at the same time points (0.553 (p = 0.040), 0.585 (p = 0.028), respectively).<h4>Conclusions/significance</h4>This study shows the development of gut barrier loss in children undergoing major non-abdominal surgery, which is related to preceding hypotension and mesenterial hypoperfusion. These data shed new light on the potential role of peroperative circulatory perturbation and intestinal barrier loss.Joep P M DerikxDick A van WaardenburgGeertje ThuijlsHenriëtte M WilligersMarianne KoenraadsAnnemarie A van BijnenErik HeinemanMartijn PoezeTon AmbergenAndré van OoijLodewijk W van RhijnWim A BuurmanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 3, Iss 12, p e3954 (2008) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Joep P M Derikx Dick A van Waardenburg Geertje Thuijls Henriëtte M Willigers Marianne Koenraads Annemarie A van Bijnen Erik Heineman Martijn Poeze Ton Ambergen André van Ooij Lodewijk W van Rhijn Wim A Buurman New Insight in Loss of Gut Barrier during Major Non-Abdominal Surgery. |
| description |
<h4>Background</h4>Gut barrier loss has been implicated as a critical event in the occurrence of postoperative complications. We aimed to study the development of gut barrier loss in patients undergoing major non-abdominal surgery.<h4>Methodology/principal findings</h4>Twenty consecutive children undergoing spinal fusion surgery were included. This kind of surgery is characterized by long operation time, significant blood loss, prolonged systemic hypotension, without directly leading to compromise of the intestines by intestinal manipulation or use of extracorporeal circulation. Blood was collected preoperatively, every two hours during surgery and 2, 4, 15 and 24 hours postoperatively. Gut mucosal barrier was assessed by plasma markers for enterocyte damage (I-FABP, I-BABP) and urinary presence of tight junction protein claudin-3. Intestinal mucosal perfusion was measured by gastric tonometry (P(r)CO2, P(r-a)CO2-gap). Plasma concentration of I-FABP, I-BABP and urinary expression of claudin-3 increased rapidly and significantly after the onset of surgery in most children. Postoperatively, all markers decreased promptly towards baseline values together with normalisation of MAP. Plasma levels of I-FABP, I-BABP were significantly negatively correlated with MAP at (1/2) hour before blood sampling (-0.726 (p<0.001), -0.483 (P<0.001), respectively). Furthermore, circulating I-FABP correlated with gastric mucosal P(r)CO2, P(r-a)CO2-gap measured at the same time points (0.553 (p = 0.040), 0.585 (p = 0.028), respectively).<h4>Conclusions/significance</h4>This study shows the development of gut barrier loss in children undergoing major non-abdominal surgery, which is related to preceding hypotension and mesenterial hypoperfusion. These data shed new light on the potential role of peroperative circulatory perturbation and intestinal barrier loss. |
| format |
article |
| author |
Joep P M Derikx Dick A van Waardenburg Geertje Thuijls Henriëtte M Willigers Marianne Koenraads Annemarie A van Bijnen Erik Heineman Martijn Poeze Ton Ambergen André van Ooij Lodewijk W van Rhijn Wim A Buurman |
| author_facet |
Joep P M Derikx Dick A van Waardenburg Geertje Thuijls Henriëtte M Willigers Marianne Koenraads Annemarie A van Bijnen Erik Heineman Martijn Poeze Ton Ambergen André van Ooij Lodewijk W van Rhijn Wim A Buurman |
| author_sort |
Joep P M Derikx |
| title |
New Insight in Loss of Gut Barrier during Major Non-Abdominal Surgery. |
| title_short |
New Insight in Loss of Gut Barrier during Major Non-Abdominal Surgery. |
| title_full |
New Insight in Loss of Gut Barrier during Major Non-Abdominal Surgery. |
| title_fullStr |
New Insight in Loss of Gut Barrier during Major Non-Abdominal Surgery. |
| title_full_unstemmed |
New Insight in Loss of Gut Barrier during Major Non-Abdominal Surgery. |
| title_sort |
new insight in loss of gut barrier during major non-abdominal surgery. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2008 |
| url |
https://doaj.org/article/c51b68d9140840a7859783612d380d1a |
| work_keys_str_mv |
AT joeppmderikx newinsightinlossofgutbarrierduringmajornonabdominalsurgery AT dickavanwaardenburg newinsightinlossofgutbarrierduringmajornonabdominalsurgery AT geertjethuijls newinsightinlossofgutbarrierduringmajornonabdominalsurgery AT henriettemwilligers newinsightinlossofgutbarrierduringmajornonabdominalsurgery AT mariannekoenraads newinsightinlossofgutbarrierduringmajornonabdominalsurgery AT annemarieavanbijnen newinsightinlossofgutbarrierduringmajornonabdominalsurgery AT erikheineman newinsightinlossofgutbarrierduringmajornonabdominalsurgery AT martijnpoeze newinsightinlossofgutbarrierduringmajornonabdominalsurgery AT tonambergen newinsightinlossofgutbarrierduringmajornonabdominalsurgery AT andrevanooij newinsightinlossofgutbarrierduringmajornonabdominalsurgery AT lodewijkwvanrhijn newinsightinlossofgutbarrierduringmajornonabdominalsurgery AT wimabuurman newinsightinlossofgutbarrierduringmajornonabdominalsurgery |
| _version_ |
1718413951606194176 |