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Altering Bowel Contents with Lactulose and other Substances prevents Endotoxemia

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Metabolic Support of the Critically Ill Patient

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 17))

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Abstract

Obstructive jaundice and liver disease are often complicated by severe infection or sepsis, especially after surgical procedures, reflected in a considerable percentage of mortality. This increased susceptibility to infection is considered to be caused by an impairment of the reticuloendothelial system (RES), together with an increased resorption of endotoxin from the gut [1].

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References

  1. Van Leeuwen PAM, Boermeester MA, Houdijk APJ, et al (1993) Clinical significance of translocation. Gut (in press)

    Google Scholar 

  2. Jacob AI, Goldberg PH, Bloom D, Degenshein GA, Korin PJ (1977) Endotoxin and bacteria in portal blood. Gastroenterology 72:1268–1270

    PubMed  CAS  Google Scholar 

  3. Nolan JP (1981) Endotoxin, RES function and liver injury. Hepatology 1:458–465

    Article  PubMed  CAS  Google Scholar 

  4. Bradfield JWB (1973) Control of spillover. The importance of Kupffer cell function in clinical medicine. Lancet 2:883–886

    Google Scholar 

  5. Sullivan BJ, Swallow CJ, Girotti MJ, Rotstein OD (1991) Bacterial translocation induces procoagulant activity in tissue macrophages. A potential mechanism for endorgan dysfunction. Arch Surg 126:586–590

    Article  PubMed  CAS  Google Scholar 

  6. O’Dwyer ST, Michie HR, Ziegler TR, Revhaug A, Smith RJ, Wilmore DW (1988) A single dose of endotoxin increases intestinal permeability in healthy humans. Arch Surg 123:1459–1464

    Article  PubMed  Google Scholar 

  7. Deitch EA, Berg RD, Specian R (1987) Endotoxin promotes the translocation of bacteria from the gut. Arch Surg 122:185–190

    Article  PubMed  CAS  Google Scholar 

  8. Van Deventer SJH, Ten Cate JW, Tytgat GNJ (1988) Intestinal endotoxemia. Gastroenterology 94:825–831

    PubMed  Google Scholar 

  9. Rodrick ML, Grbic JT, Moss N, et al (1987) Endotoxin in vivo may cause a functional blockade of in vitro cellular immune responses. Surg Forum 38:98–100

    Google Scholar 

  10. Kaplan JE (1980) The role of the reticuloendothelial system in control of hemostatic and thrombotic mechanisms. In: Altura BM, Saba TM (eds) Pathophysiology of the reticuloendothelial system. Raven Press, New York, pp 111–131

    Google Scholar 

  11. Greve JW, Gouma DJ, Soeters PB, Buurman WA (1990) Suppression of cellular immunity on obstructive jaundice is caused by endotoxins. Gastroenterology 98:478–485

    PubMed  CAS  Google Scholar 

  12. Beachey EH (1981) Bacterial adherence adhesin-receptor interactions mediating the attachment of bacteria to mucosal surfaces. J Infect Dis 143:325–345

    Article  PubMed  CAS  Google Scholar 

  13. Deitch EA (1990) The role of intestinal barrier failure and bacterial translocation in the development of systemic infection and multiple organ failure. Arch Surg 125:403–404

    Article  PubMed  CAS  Google Scholar 

  14. Granger DN, Richardson PDI, Kvietys PR, Mortillaro NA (1980) Intestinal blood flow. Gastroenterology 78:837–863

    PubMed  CAS  Google Scholar 

  15. Nelson DP, King CE, Dodd SL, Schumacker PT, Cain SM (1987) Systemic and intestinal limits of O2 extraction in the dog. J Appl Physiol 63:387–394

    PubMed  CAS  Google Scholar 

  16. Antonsson JB, Fiddian-Green RG (1991) The role of the gut and multiple system organ failure. Eur J Surg 157:3–12

    PubMed  CAS  Google Scholar 

  17. Houdijk APJ, Van Leeuwen PAM, Van Lambalgen AA, Bading JR, Boermeester MA, Wesdorp RIC (1993) Preoperative enteral cholestyramine prevents hemodynamic disturbances following surgery in obstructive jaundice (in press)

    Google Scholar 

  18. McNeill JR, Stark RD, Greeway CV (1970) Intestinal vasoconstriction after hemorrhage: Roles of vasopressin and angiotensin. Am J Physiol 219:1342–1347

    PubMed  CAS  Google Scholar 

  19. Gilmour DG, Aitkenhead AR, Hothersall AP, et al (1980) The effect of hypovolemia on colon blood flow in the dog. Br J Surg 67:82–87

    Article  PubMed  CAS  Google Scholar 

  20. Deitch EA, Xu D, Qi X, Berg RD (1991) Bacterial translocation from the gut impairs systemic immunity. Surgery 109:269–276

    PubMed  CAS  Google Scholar 

  21. Mc Ghee JR, Kiyono H, Alley CD (1984) Gut bacterial endotoxin: Influence on gut- associated lymphoreticular tissue and host immune function. Surv Immunol Res 3:241–252

    PubMed  CAS  Google Scholar 

  22. Steffan AM, Hirn A (1986) C3 mediated phagocytosis induced in murine Kupffer cells by in vitro activation with endotoxin. Gastro Clin Biol 10:117–121

    CAS  Google Scholar 

  23. Richards PS, Saba TM (1985) Effect of endotoxin on fibronectin and Kupffer cell activity. Hepatology 5:32–37

    Article  PubMed  CAS  Google Scholar 

  24. Loegering DJ, Schneidkraut MJ (1979) Effect of endotoxin on alpha-2-SB-opsonic protein activity and reticuloendothelial system phagocytic function. J Reticuloendothel Soc 26:197–204

    PubMed  CAS  Google Scholar 

  25. Marshall JC, Lee C, Meakins JL, Michel RP, Christou NV (1987) Kupffer cell modulation of the systemic immune response. Arch Surg 122:191–196

    Article  PubMed  CAS  Google Scholar 

  26. Walvatne G, Cerra FB (1990) Hepatic dysfunction in multiple organ failure. In: Deitch EA (ed) Multiple organ failure. Pathophysiology and basic concepts of therapy. Thieme, New York, pp 241–260

    Google Scholar 

  27. Keller GA, West MA, Cerra FB, Simmons RL (1985) Multiple systems organ failure. Modulation of hepatocyte protein synthesis by endotoxin activated Kupffer cells. Ann Surg 201:87–95

    PubMed  CAS  Google Scholar 

  28. Ulevitch RJ, Mathison JC, Schumann RR, Tobias PS (1990) A new model of macrophage stimulation by bacterial lipopolysaccharide. J Trauma 30:189–192

    Article  Google Scholar 

  29. Faist E, Storck M, Hultner L, et al (1992) Functional analysis of monocyte activity through synthesis patterns of proinflammatory cytokines and neopterin in patients in surgical intensive care. Surgery 112:562–572

    PubMed  CAS  Google Scholar 

  30. Van Leeuwen PAM, Hong RW, Rounds JD, Rodrick ML, Wilmore DW (1991) Hepatic failure and coma after liver resection is reversed by manipulation of gut contents: The role of endotoxin. Surgery 110:169–175

    PubMed  Google Scholar 

  31. Nakagawa K, Matsubara S, Ouchi K, Owada Y, Yajima Y (1986) Endotoxemia after abdominal surgery. Tohoku J Exp Med 150:273–280

    Article  PubMed  CAS  Google Scholar 

  32. Schildt BW (1970) Function of RES after thermal and mechanical trauma in mice. Acta Chir Scand 136:359–364

    PubMed  CAS  Google Scholar 

  33. Saba TM (1975) RES systemic host defense after surgery and traumatic shock. Circ Shock 2:91–108

    Google Scholar 

  34. Cornell RP (1985) Restriction of gut-derived endotoxin impairs DNA synthesis for liver regeneration. Am J Physiol 249 : R563–R569

    PubMed  CAS  Google Scholar 

  35. Satoh A, Adachi K, Yamazaki M, Mizuno D (1991) TNF-driven inflammation during mouse liver regeneration after partial hepatectomy and its role in growth regulation of liver. Mol Biother 3:136–147

    PubMed  CAS  Google Scholar 

  36. Feingold KR, Barker ME, Jones AL, Grunfeld C (1991) Localization of tumor necrosis factor-stimulated DNA synthesis in the liver. Hepatology 13:773–779

    PubMed  CAS  Google Scholar 

  37. Souba WW, Herskowitz K, Salloum RM (1990) Gut glutamine metabolism. JPEN 14:45–50

    Article  Google Scholar 

  38. Slade MS, Simmons RL, Yunis E, et al (1975) Immunodepression after major surgery in normal patients. Surgery 78:363–372

    PubMed  CAS  Google Scholar 

  39. Christou NV, Mannick JA, West MA, Kasper DL (1987) Cellular immune dysfunction in response to injury. Arch Surg 122:240–241

    Google Scholar 

  40. Wolfe JHN, Wu AVO, O’Connor NE, Saporoschetz I, Mannick JA (1982) Anergy, immunosuppressive serum, and impaired lymphocyte blastogenesis in burn patients. Arch Surg 117:1266–1271

    Article  PubMed  CAS  Google Scholar 

  41. Moss N, Gough DB, Jordan A, Grbic JT, Rodrick ML, Mannick JA (1988) Correlation of susceptibility to sepsis with suppression of cell mediated immunity. Surgery 104:882–887

    PubMed  CAS  Google Scholar 

  42. Rodrick ML, Michie HR, Moss NM, et al (1989) In vivo infusion of a single dose of endotoxin in healthy humans causes in vitro alterations of both T-cell and adherent cell functions. In: Faist E (ed) Host defense dysfunction in trauma shock and sepsis. Springer-Verlag, Berlin Heidelberg, pp 475–483

    Google Scholar 

  43. Munster AM, Winchurch RA, Thupari JM, Ernst CB (1986) Reversal of postburn immunosuppression with low-dose Polymyxin B. Br J Trauma 26:995–998

    Article  CAS  Google Scholar 

  44. Wait RB, Kahng KU (1989) Renal failure complicating obstructive jaundice. Am J Surg 157:256–263

    Article  PubMed  CAS  Google Scholar 

  45. Green J, Beyar R, Bomzon L, Finberg JPM, Better OS (1984) Jaundice, the circulation and the kidney. Nephrol 37:145–152

    CAS  Google Scholar 

  46. Wardle EN, Wright NA (1970) Endotoxin and acute renal failure associated with obstructive jaundice. Br Med J 4:472–474

    Article  PubMed  CAS  Google Scholar 

  47. Bailey ME (1976) Endotoxin, bile salts and renal function in obstructive jaundice. Br J Surg 63:774–778

    Article  PubMed  CAS  Google Scholar 

  48. Wilkinson SP, Moodie H, Stamatakis JD, Kakkar W, Williams R (1976) Endotoxemia and renal failure in cirrhosis and obstructive jaundice. Br Med J 2:1415–1418

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. P. A. M. van Leeuwen
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  2. M. A. Boermeester
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  3. A. P. J. Houdijk
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Editor information

Editors and Affiliations

  1. Laboratory for Surgical Metabolism, Brigham and Women’s Hospital, 75 Francis Street, Boston, Massachussetts, 02115, USA

    Douglas W. Wilmore

  2. L. Deloyers Laboratory for Experimental Surgery, Free University of Brussels, Avenue J. Wybran 40, 1070, Brussels, Belgium

    Yvon A. Carpentier

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© 1993 Springer-Verlag Berlin Heidelberg

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van Leeuwen, P.A.M., Boermeester, M.A., Houdijk, A.P.J. (1993). Altering Bowel Contents with Lactulose and other Substances prevents Endotoxemia. In: Wilmore, D.W., Carpentier, Y.A. (eds) Metabolic Support of the Critically Ill Patient. Update in Intensive Care and Emergency Medicine, vol 17. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-85011-0_17

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  • DOI: https://doi.org/10.1007/978-3-642-85011-0_17

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-85013-4

  • Online ISBN: 978-3-642-85011-0

  • eBook Packages: Springer Book Archive

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