Effects of CO<sub>2</sub> pneumoperitoneum on bacterial growth and translocation of acute peritonitis rats _CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

OU Mengchuan ¹ , YANG Xianjin ² , LUO Yun ³ ,  WANG Chongshu ³

1. Department of Gastrointestinal Surgery, The Sixth People’s Hospital of Chengdu, Chengdu 610051, P. R. China;
2. The Second Department of General Surgery, The First People’s Hospital of Neijiang, Neijiang, Sichuan 641000, P. R. China;
3. The First Department of General Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;

Corresponding?author：

WANG Chongshu, Email: chongs-wang@163.com

Keywords：

acute peritonitis; CO₂ pneumoperitoneum; endotoxin; bacterial translocation; rat

DOI：

10.7507/1007-9424.201806075

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Objective To study the effects of different carbon dioxide pneumoperitoneum pressure and time on abdominal cavity infection bacteria of peritonitis in rats, including bacteria growth and bacterial translocation. Methods Sixty Sprague Dawley rats were injected with Eseherichia coli into the abdominal cavity to establish models of intra-abdominal infection. To give 3 types of pneumoperitoneum pressure for the experimental group: 15 mm Hg (1 mm Hg=0.133 kPa) for high pressure group, 5 mm Hg for low pressure group, and blank control group for no-pneumoperitoneum. To give 2 types of experimental period: 1 h and 3 h. These 60 Sprague Dawley rats were randomly divided intomoperi 6 groups by random number table. They were treated by different pneumoperitoneum pressure and time. All rats were killed at the end of the carbon-dioxide pneumo-peritoneum experiment. Peritoneal lavage fluids and portal vein blood were taken for microbiological examinations and culture. The endotoxin content in portal vein blood was detected too. Results ① Bacteria content: bacteria counts of different pneumoperitoneum pressure groups were obviously different (F=9.02, P=0.020), bacteria counts of different experimental period groups were obviously different (F=8.47, P=0.003), the effect of time was different in different pneumoperitoneum pressure groups (F=8.07, P=0.020). ② Bacterial translocation: Bacterial translocation occurred in all 6 groups. Blood culture positive rates were similar between 1 h group and 3 h group at 3 types of pneumoperitoneum pressure groups (P>0.05). The positive rate of blood culture in high pneumoperitoneum group was significantly higher compared with the no-pneumoperitoneum group (P<0.05). ③ The endotoxin content: the endotoxin content of different pneumoperitoneum pressure groups were obviously different (F=14.70, P<0.01), the endotoxin content in plasma increased obviously in high pressure group compared with low pressure group (P=0.018) and no-pneumoperitoneum group (P<0.01), the endotoxin content in plasma increased obviously in low pressure group compared with no-pneumoperitoneum group (P=0.005). The endotoxin content of different experimental period groups were obviously different (F=148.90, P<0.01), the endotoxin content in plasma increased obviously in 3 h group compared with 1 h group. There were no significant difference in the effect of time with different pneumoperitoneum pressure groups (F=0.14, P=0.874). Conclusion CO₂pneumoperitoneum promoted intestinal bacterial endotoxin and bacterial translocation in peritonitis of rats, which increased with the pressure and time.

Citation： OU Mengchuan, YANG Xianjin, LUO Yun, WANG Chongshu. Effects of CO₂ pneumoperitoneum on bacterial growth and translocation of acute peritonitis rats . CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(11): 1313-1317. doi: 10.7507/1007-9424.201806075 Copy

1.	Kos M, Kuebler JF, Jesch NK, et al. Carbon dioxide differentially affects the cytokine release of macrophage subpopulations exclusively via alteration of extracellular pH. Surg Endosc, 2006, 20(4): 570-576.
2.	Suematsu T, Hirabayashi Y, Shiraishi N, et al. Morphology of the murine peritoneum after pneumoperitoneum vs laparotomy. Surg Endosc, 2001, 15(9): 954-958.
3.	Chatzimavroudis G, Pavlidis TE, Koutelidakis I, et al. CO(2) pneumoperitoneum prolongs survival in an animal model of peritonitis compared to laparotomy. J Surg Res, 2009, 152(1): 69-75.
4.	Chawla BK, Teitelbaum DH. Profound systemic inflammatory response syndrome following non-emergent intestinal surgery in children. J Pediatr Surg, 2013, 48(9): 1936-1940.
5.	Peng H, Zhang J, Cai C, et al. The influence of carbon dioxide pneumoperitoneum on systemic inflammatory response syndrome and bacterial translocation in patients with bacterial peritonitis caused by acute appendicitis. Surg Innov, 2018, 25(1): 7-15.
6.	杜慧竟, 石繼春, 李江姣, 等. 細菌懸液兩種計數方法的比較. 中國醫藥導報, 2016, 13(6): 146-149.
7.	黎介壽. 加強對腸屏障功能障礙的研究. 中國臨床營養雜志, 2003, 11(4): 243-245.
8.	Steinberg SM. Bacterial translocation: what it is and what it is not. Am J Surg, 2003, 186(3): 301-305.
9.	李琴, 劉立新. 腸黏膜屏障與腸源性內毒素血癥的關系研究進展. 中華消化病與影像雜志: 電子版, 2012, 2(4): 291-294.
10.	Menconi MJ, Salzman AL, Unno N, et al. Acidosis induces hyperpermeability in Caco-2BBe cultured intestinal epithelial monolayers. Am J Physiol, 1997, 272(5 Pt 1): G1007-G1021.
11.	程君濤, 肖光夏, 馮智, 等. 腹內高壓致腸黏膜屏障損傷的實驗研究. 中華燒傷雜志, 2006, 22(2): 33-37.
12.	趙曉琴, 陳英, 鄺曉聰, 等. 腹內高壓對腸黏膜屏障功能損傷的影響. 世界華人消化雜志, 2013, 21(34): 3790-3798.
13.	Tu? T, Ozbas S, Tekeli A, et al. Does pneumoperitoneum cause bacterial translocation? J Laparoendosc Adv Surg Tech A, 1998, 8(6): 401-407.
14.	Strier A, Kravarusic D, Coran AG, et al. The effect of elevated intra-abdominal pressure on TLR4 signaling in intestinal mucosa and on intestinal bacterial translocation in a rat. J Laparoendosc Adv Surg Tech A, 2017, 27(2): 211-216.
15.	李錕, 吳承堂, 張軍花, 等. 嚴重腹腔感染早期腸黏膜病理損害的實驗觀察. 南方醫科大學學報, 2006, 26(2): 202-204.
16.	Vaishnavi C. Translocation of gut flora and its role in sepsis. Indian J Med Microbiol, 2013, 31(4): 334-342.
17.	Li Y, Ren J, Wu X, et al. Intra-abdominal infection combined with intra-abdominal hypertension aggravates the intestinal mucosal barrier dysfunction. Biosci Rep, 2018, 38(1): 1-10.
18.	Pi?ero-Fernandez S, Chimerel C, Keyser UF, et al. Indole transport across Escherichia coli membranes. J Bacteriol, 2011, 193(8): 1793-1798.
19.	Martínez H, Buhse T, Rivera M, et al. Effect of the volume-to-surface ratio of cultures on Escherichia coli growth: an experimental and theoretical analysis. Curr Microbiol, 2012, 65(1): 60-65.
20.	Merlin C, Masters M, McAteer S, et al. Why is carbonic anhydrase essential to Escherichia coli? J Bacteriol, 2003, 185(21): 6415-6424.
21.	Dixon NM, Kell DB. The inhibition by CO₂ of the growth and metabolism of micro-organisms. J Appl Bacteriol, 1989, 67(2): 109-136.
22.	Sare M, Yesilada O, Gürel M, et al. Effects of CO₂ insufflation on bacterial growth in rats with Escherichia coli-induced experimental peritonitis. Surg Laparosc Endosc, 1997, 7(1): 38-41.
23.	Sare M, Demirkiran AE, Tastekin N, et al. Effects of laparoscopic models on anaerobic bacterial growth with bacteroides fragilis in experimentally induced peritonitis. J Laparoendosc Adv Surg Tech A, 2003, 13(3): 175-179.
24.	Matsumoto T, Tsuboi S, Dolgor B, et al. The effect of gases in the intraperitoneal space on cytokine response and bacterial translocation in a rat model. Surg Endosc, 2001, 15(1): 80-84.
25.	Casaroli AA, Mimica LM, Fontes B, et al. The effects of pneumoperitoneum and controlled ventilation on peritoneal lymphatic bacterial clearance: experimental results in rats. Clinics (Sao Paulo), 2011, 66(9): 1621-1625.

1. Kos M, Kuebler JF, Jesch NK, et al. Carbon dioxide differentially affects the cytokine release of macrophage subpopulations exclusively via alteration of extracellular pH. Surg Endosc, 2006, 20(4): 570-576.
2. Suematsu T, Hirabayashi Y, Shiraishi N, et al. Morphology of the murine peritoneum after pneumoperitoneum vs laparotomy. Surg Endosc, 2001, 15(9): 954-958.
3. Chatzimavroudis G, Pavlidis TE, Koutelidakis I, et al. CO(2) pneumoperitoneum prolongs survival in an animal model of peritonitis compared to laparotomy. J Surg Res, 2009, 152(1): 69-75.
4. Chawla BK, Teitelbaum DH. Profound systemic inflammatory response syndrome following non-emergent intestinal surgery in children. J Pediatr Surg, 2013, 48(9): 1936-1940.
5. Peng H, Zhang J, Cai C, et al. The influence of carbon dioxide pneumoperitoneum on systemic inflammatory response syndrome and bacterial translocation in patients with bacterial peritonitis caused by acute appendicitis. Surg Innov, 2018, 25(1): 7-15.
6. 杜慧竟, 石繼春, 李江姣, 等. 細菌懸液兩種計數方法的比較. 中國醫藥導報, 2016, 13(6): 146-149.
7. 黎介壽. 加強對腸屏障功能障礙的研究. 中國臨床營養雜志, 2003, 11(4): 243-245.
8. Steinberg SM. Bacterial translocation: what it is and what it is not. Am J Surg, 2003, 186(3): 301-305.
9. 李琴, 劉立新. 腸黏膜屏障與腸源性內毒素血癥的關系研究進展. 中華消化病與影像雜志: 電子版, 2012, 2(4): 291-294.
10. Menconi MJ, Salzman AL, Unno N, et al. Acidosis induces hyperpermeability in Caco-2BBe cultured intestinal epithelial monolayers. Am J Physiol, 1997, 272(5 Pt 1): G1007-G1021.
11. 程君濤, 肖光夏, 馮智, 等. 腹內高壓致腸黏膜屏障損傷的實驗研究. 中華燒傷雜志, 2006, 22(2): 33-37.
12. 趙曉琴, 陳英, 鄺曉聰, 等. 腹內高壓對腸黏膜屏障功能損傷的影響. 世界華人消化雜志, 2013, 21(34): 3790-3798.
13. Tu? T, Ozbas S, Tekeli A, et al. Does pneumoperitoneum cause bacterial translocation? J Laparoendosc Adv Surg Tech A, 1998, 8(6): 401-407.
14. Strier A, Kravarusic D, Coran AG, et al. The effect of elevated intra-abdominal pressure on TLR4 signaling in intestinal mucosa and on intestinal bacterial translocation in a rat. J Laparoendosc Adv Surg Tech A, 2017, 27(2): 211-216.
15. 李錕, 吳承堂, 張軍花, 等. 嚴重腹腔感染早期腸黏膜病理損害的實驗觀察. 南方醫科大學學報, 2006, 26(2): 202-204.
16. Vaishnavi C. Translocation of gut flora and its role in sepsis. Indian J Med Microbiol, 2013, 31(4): 334-342.
17. Li Y, Ren J, Wu X, et al. Intra-abdominal infection combined with intra-abdominal hypertension aggravates the intestinal mucosal barrier dysfunction. Biosci Rep, 2018, 38(1): 1-10.
18. Pi?ero-Fernandez S, Chimerel C, Keyser UF, et al. Indole transport across Escherichia coli membranes. J Bacteriol, 2011, 193(8): 1793-1798.
19. Martínez H, Buhse T, Rivera M, et al. Effect of the volume-to-surface ratio of cultures on Escherichia coli growth: an experimental and theoretical analysis. Curr Microbiol, 2012, 65(1): 60-65.
20. Merlin C, Masters M, McAteer S, et al. Why is carbonic anhydrase essential to Escherichia coli? J Bacteriol, 2003, 185(21): 6415-6424.
21. Dixon NM, Kell DB. The inhibition by CO₂ of the growth and metabolism of micro-organisms. J Appl Bacteriol, 1989, 67(2): 109-136.
22. Sare M, Yesilada O, Gürel M, et al. Effects of CO₂ insufflation on bacterial growth in rats with Escherichia coli-induced experimental peritonitis. Surg Laparosc Endosc, 1997, 7(1): 38-41.
23. Sare M, Demirkiran AE, Tastekin N, et al. Effects of laparoscopic models on anaerobic bacterial growth with bacteroides fragilis in experimentally induced peritonitis. J Laparoendosc Adv Surg Tech A, 2003, 13(3): 175-179.
24. Matsumoto T, Tsuboi S, Dolgor B, et al. The effect of gases in the intraperitoneal space on cytokine response and bacterial translocation in a rat model. Surg Endosc, 2001, 15(1): 80-84.
25. Casaroli AA, Mimica LM, Fontes B, et al. The effects of pneumoperitoneum and controlled ventilation on peritoneal lymphatic bacterial clearance: experimental results in rats. Clinics (Sao Paulo), 2011, 66(9): 1621-1625.

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Effects of CO2 pneumoperitoneum on bacterial growth and translocation of acute peritonitis rats

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Effects of CO₂ pneumoperitoneum on bacterial growth and translocation of acute peritonitis rats