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Influ?ncia da laparoscopia e da laparotomia na gasometria, leucometria diferencial e citocinas em modelo de sepse abdominal em ratos

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Previous issue date: 2005-10-27 / Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. Methods: Wistar rats were randomly assigned to five groups: control (anesthesia only), laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNF&#945;, IL-1&#946;, IL-6 were determined in intraperitoneal fluid (by ELISA). Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. Results: Peritoneal TNF&#945;, IL-1&#946; and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (p<0.05). TNF&#945;, IL-1&#946; and IL-6 expression was lower in the laparoscopic than in laparotomic sepsis (p<0.05). Rats from laparoscopic cecum ligation and puncture group developed significant hypercarbic acidosis in blood and subperitoneal fluid when compared to open procedure group. Total white blood cells and lymphocytes were significantly lower in laparoscopic cecum ligation and puncture rats than in the laparotomic (p<0.01). Nevertheless, the laparotomic cecum ligation rats had a significant increase in blood neutrophils and eosinophils when compared with controls (p<0.05). Conclusions: This study demonstrates that the CO2 pneumoperitoneum reduced the inflammatory and immune response in an animal model of peritonitis with respect to intraperitoneal cytokines, white blood cell count and clinical correlates of sepsis. The pneumoperitoneum produced hypercarbic acidosis in septic animals / A cirurgia laparosc?pica est? associada com trauma reduzido e baixa resposta metab?lica na fase aguda do trauma, quando comparada com a cirurgia aberta. As citocinas e o balan?o ?cido-base s?o fatores importantes da resposta biol?gica ao trauma cir?rgico-anest?sico. O objetivo deste estudo foi determinar se o pneumoperit?nio com CO altera a express?o das citocinas intraperitoneais, a gasometria do sangue arterial, dos exsudatos intraperitoneal e subperitoneal, e a contagem diferencial de leuc?citos em ratos com sepse abdominal. M?todo: Ratos Wistar foram aleatoriamente distribu?dos em cinco grupos: controle (somente 2anestesia), laparotomia, pneumoperit?nio com CO2, ligadura e pun??o do ceco por laparotomia, ligadura e pun??o do ceco por laparoscopia. Ap?s 30 minutos dos procedimentos, sangue arterial foi colhido para leucometria em hemocit?metro. FNT&#945;, IL-1&#946; e IL-6 foram dosadas no lavado intraperitoneal (por ELISA). Os par?metros gasosos foram medidos no sangue arterial e nos exsudatos intraperitoneal e subperitoneal. Resultados: Os valores de FNT&#945;, IL-1&#946; e IL-6 foram significantemente menores nos ratos submetidos ao pneumoperit?nio do que em todos os outros grupos (p<0.05). Express?o de FNT&#945;, IL-1&#946; e IL-6 foi menor no grupo sepse induzida por laparoscopia do que por laparotomia (p<0.05). Os ratos submetidos ? ligadura e pun??o do ceco por via laparosc?pica desenvolveram acidose hiperc?rbica no sangue arterial e exsudato subperitoneal, mais intensa do que no grupo sepse laparot?mica. Leucopenia e linfopenia foram mais acentuadas no grupo sepse laparosc?pica (p<0.01). Entretanto, os animais submetidos a sepse laparot?mica desenvolveram significante aumento de neutr?filos e eosin?filos quando comparados com os controles (p<0.05). Conclus?es: Este estudo demonstrou que o pneumoperit?nio com CO contribuiu para reduzir a resposta inflamat?ria e imunol?gica em ratos submetidos a modelo de sepse abdominal, no que diz respeito a citocinas intraperitoneais e leucometria diferencial. O pneumoperit?nio tamb?m contribuiu para instala??o de acidose hiperc?rbica nos ratos s?pticos

Identiferoai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/13419
Date27 October 2005
CreatorsAra?jo Filho, Irami
ContributorsCPF:07117701404, http://lattes.cnpq.br/9873289951810864, Aguiar, Jos? Lamartine de Andrade, CPF:04588851420, http://lattes.cnpq.br/2087256689863426, Cavalcante, Jeancarlo Fernandes, CPF:70231346468, http://lattes.cnpq.br/8403344128848984, Medeiros, Aldo da Cunha
PublisherUniversidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Ci?ncias da Sa?de, UFRN, BR, Ci?ncias da Sa?de
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis
Formatapplication/pdf
Sourcereponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN
Rightsinfo:eu-repo/semantics/openAccess

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