Total hepatic warm ischemia and reperfusion associated with controlled hemorrhagic shock: effects of neutrophil sequestration in distal ileum and sigmoid colon of rats

BACKGROUND: The purpose of this experimental work was to study the effects of total hepatic ischemia and reperfusion on the accumulation of neutrophils in the terminal ileum and sigmoid colon of rats, under normal conditions and under controlled hemorrhagic shock. METHOD: Thirty two adult male Wistar rats, were divided into four groups: Sham group, was submitted to standard procedures for a period of 60 min. of observation; Shock group, was submitted to controlled hemorrhagic shock (mean arterial blood pressure = 40mmHg, 20 min.) followed by fluid resuscitation (lactated Ringer's solution + blood, 3:1) and reperfusion for 60 min.; Pringle group, was submitted to total hepatic ischemia for 15 min. and reperfusion for 60 min.; Total group, was submitted to controlled hemorrhagic shock for 15 min. followed by volemic resuscitation (lactated Ringer's solution + blood, 3:1) and reperfusion for 60 min. Neutrophils counting on intestinal tissues was performed after euthanasia. RESULTS: Values for neutrophils counting on the distal ileum indicate that, only animals from Shock group differed from other groups (p<0.001) (Sham 1.33±0.55, Shock 5.48±2.65, Pringle 2.47±1.38, Total 2.44±0.56). On sigmoid colon, Shock group differed only from Sham group (p=0.021) and did not differ from other groups (Sham 0.66±0.44, Shock 2.08±1.11, Pringle 1.04±0.71, Total 1.21±1.03). CONCLUSIONS: Differently from hemorrhagic shock, total hepatic ischemia for 15 minutes, followed by 60 minutes of reperfusion, did not present significant neutrophils accumulation on distal ileum and sigmoid colon tissues.OBJETIVO: Estudar os efeitos da isquemia e reperfusão hepática total sobre acúmulo de neutrófilos no íleo terminal e cólon sigmóide de ratos, em condições de normalidade e submetidos ao estado de choque hemorrágico controlado. MÉTODO: 32 ratos Wistar, machos, foram divididos em quatro grupos de oito animais cada: grupo Sham, submetido aos procedimentos padrões com um período de 60 minutos de observação; grupo Choque, submetido a choque hemorrágico controlado (PAM = 40mmHg, 20min) seguido de reposição volêmica (Ringer lactato + sangue, 3:1) e reperfusão (60min); grupo Pringle, submetido à isquemia hepática total (15min.) e reperfusão (60min); grupo Total submetido a choque hemorrágico controlado (20min) seguido de reposição volêmica (Ringer lactato + sangue, 3:1), isquemia hepática (15min) e reperfusão (60min). Após o sacrifício dos animais, procedeu-se à contagem de neutrófilos nos segmentos intestinais. RESULTADOS: Na contagem de neutrófilos no íleo terminal, apenas o grupo Choque diferiu dos demais (p