Intensive Care Medicine

, 35:933

Immediate postconditioning during reperfusion attenuates intestinal injury

  • Ke-Xuan Liu
  • Yun-Sheng Li
  • Wen-Qi Huang
  • Shu-Qing Chen
  • Zhong-Xin Wang
  • Jia-Xin Liu
  • Zhengyuan Xia
Experimental

DOI: 10.1007/s00134-009-1428-1

Cite this article as:
Liu, KX., Li, YS., Huang, WQ. et al. Intensive Care Med (2009) 35: 933. doi:10.1007/s00134-009-1428-1

Abstract

Objective

To test the hypothesis that immediate but not delayed ischemic postconditioning (IPo) during reperfusion attenuates intestinal injury, and that ischemic preconditioning (IPC) and IPo may confer synergy in intestinal protection.

Design and setting

Prospective laboratory animal study with concurrent control.

Subjects

Adult Sprague–Dawley rats.

Interventions

Intestinal ischemia/reperfusion (II/R) injury in rats was produced by clamping superior mesenteric artery for 60 min followed by 60 min reperfusion; IPC was elicited by 10 min ischemia and 10 min reperfusion before index ischemia; IPo was performed by three cycles of 30 s reperfusion and 30 s ischemia initiated either immediately at the onset of reperfusion (IPo) or after reperfusion for 3 min (delayed-IPo). Combination of IPC and IPo was performed by combining both protocols.

Measurements and main results

Intestinal ischemia/reperfusion resulted in significant intestinal injury evidenced as significant increase in Chiu’s scores and wet-to-dry intestine weight ratio accompanied with increases in plasma levels of tumor necrosis factor-α and interleukin-6, as well as increases in the intestinal tissue lipid peroxidation product malonediadehyde and myeloperoxidase activity as compared to control animals (all P < 0.05). All these changes were significantly attenuated either by IPC or IPo or their combination (P < 0.05), and not by delayed-IPo (P > 0.05). IPC and IPo showed synergistic protection compared with either protocol alone.

Conclusion

Ischemic postconditioning reduces intestinal injury, in part, by inhibiting oxidative injury, neutrophils filtration and proinflammatory response. The early period of reperfusion is critical to intestinal protection by IPo, and intestinal protection with IPo can be enhanced by IPC.

Keywords

PostconditioningPreconditioningIntestinal reperfusion injuryOxidative injury

Supplementary material

134_2009_1428_MOESM1_ESM.doc (26 kb)
Supplementary material 1 (DOC 26 kb)

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Ke-Xuan Liu
    • 1
  • Yun-Sheng Li
    • 1
  • Wen-Qi Huang
    • 1
  • Shu-Qing Chen
    • 2
  • Zhong-Xin Wang
    • 1
  • Jia-Xin Liu
    • 1
  • Zhengyuan Xia
    • 3
  1. 1.Department of Anesthesiology, The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina
  2. 2.Department of Gynecology and Obstetrics, The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina
  3. 3.Department of Anesthesiology, Research Centre of Heart, Brain, Hormone and Healthy AgingUniversity of Hong KongHong Kong SARChina