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Integrity of gut Mucosa During Anaesthesia in Major Abdominal Surgery
Gulam, Danijela; Dmitrović, Branko; Kvolik, Slavica; Barbić, Jerko; Zibar, Lada; Kovačić, Damir (2011)
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Gulam, D., Dmitrović, B., Kvolik, S., Barbić, J., Zibar, L. & Kovačić, D. (2011). Integrity of gut Mucosa During Anaesthesia in Major Abdominal Surgery. Collegium antropologicum, 35. (2), 445-451. Retrieved from https://urn.nsk.hr/urn:nbn:hr:239:105605

Gulam, Danijela, et al. "Integrity of gut Mucosa During Anaesthesia in Major Abdominal Surgery." Collegium antropologicum, vol. 35, no. 2, 2011, pp. 445-451. https://urn.nsk.hr/urn:nbn:hr:239:105605

Gulam, Danijela, Branko Dmitrović, Slavica Kvolik, Jerko Barbić, Lada Zibar and Damir Kovačić. "Integrity of gut Mucosa During Anaesthesia in Major Abdominal Surgery." Collegium antropologicum 35, no. 2 (2011): 445-451. https://urn.nsk.hr/urn:nbn:hr:239:105605

Gulam, D., et al. (2011) 'Integrity of gut Mucosa During Anaesthesia in Major Abdominal Surgery', Collegium antropologicum, 35(2), pp. 445-451. Available at: https://urn.nsk.hr/urn:nbn:hr:239:105605 (Accessed 24 February 2020)

Gulam D, Dmitrović B, Kvolik S, Barbić J, Zibar L, Kovačić D. Integrity of gut Mucosa During Anaesthesia in Major Abdominal Surgery. Collegium antropologicum [Internet]. 2011 [cited 2020 February 24];35(2):445-451. Available at: https://urn.nsk.hr/urn:nbn:hr:239:105605

D. Gulam, B. Dmitrović, S. Kvolik, J. Barbić, L. Zibar and D. Kovačić, "Integrity of gut Mucosa During Anaesthesia in Major Abdominal Surgery", Collegium antropologicum, vol. 35, no. 2, pp. 445-451, 2011. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:239:105605. [Accessed: 24 February 2020]

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Metadata
Title (english)Integrity of gut Mucosa During Anaesthesia in Major Abdominal Surgery
Title (croatian)Cjelovitost sluznice tankog crijeva tijekom anestezije kod velikih kirurških zahvata trbuha
AuthorDanijela Gulam
MBZ: 295491
AuthorBranko Dmitrović
MBZ: 130004
AuthorSlavica Kvolik
MBZ: 259895
AuthorJerko Barbić
MBZ: 258420
AuthorLada Zibar
MBZ: 254864
AuthorDamir Kovačić
Author's institution(Clinical hospital center Osijek)
Author's institutionJosip Juraj Strossmayer University of Osijek
Faculty of Medicine Osijek
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Anesthesiology and Reanimatology
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Surgery
Abstract (english)
The aim of the study was to examine a perfusion and integrity of small bowel in 60 subsequent patients during the major open abdominal surgery which lasted from 2 to 7 hours. Two samples of the intestinal mucosa were removed: at the beginning, and at the end of the surgical procedure in general anaesthesia. A mucosal injury was classified into 4 grades. pH, PCO2 and lactate level were measured in the blood samples from the arterial and mesenteric vein in one hour time intervals. The changes of intestinal mucosa were found in 31 patients (51.7%): in 19 patients (31.7%) grade 1 changes were recorded, in 10 patients (16.7%) grade 2, and in 2 patients (3.3%) grade 3. Grade 4 lesions were not recorded. There was a statistically significant correlation between grades of the mucosal damage and the surgery duration (p=0.001). Analysis during the one hour intervals showed that there was no exact time point when the significant aggravation of the pathohistological changes in intestinal mucosa occurred. However, when patients were allocated into two subgroups with surgical procedures lasting less than 4 hours and more than 4 hours, there was a statistically significant difference in the grades of mucosal damage between subgroups (p<0.05). More biopsies without pathohistological changes were observed in the patients whose procedure duration was < 4 hours. A significantly higher lactate concentrations in arterial and mesenteric venous blood were observed in the patients with pathohistological changes at 6 hours time point as compared to 2 hour time point in the patients without pathohistological changes (p<0.05). During the open abdominal surgery in general anaesthesia, the length of the procedure influences the grade of the intestinal mucosa injury. Deterioration of the pathohistological findings in the intestinal mucosa correlates with high lactate blood level, suggesting that the cause of these changes may result from tissue hypoxia.
Abstract (croatian)
Cilj studije je bio ispitati perfuziju i cjelovitost sluznice tankog crijeva tijekom anestezije i kirurškog zahvata na otvorenom trbuhu kod 60 bolesnika u postupcima razli~itog trajanja. Tijekom operacije uzeta su dva uzorka crijevne sluznice: T0 na početku postupka i TN na kraju postupka (N=trajanje postupka u satima, od 2 do 7 sati). Svi bioptički uzorci su pregledani a uočena oštečenja sluznice klasificirana u 4 stupnja. Promjene crijevne sluznice su nađene u 31 bolesnika (51,7%): u 19 bolesnika (31,7%) zabilježene su promjene 1. stupnja; u 10 bolesnika (16,7%) promjene 2. stupnja; u 2 bolesnika (3,3%) promjene 3. stupnja. Oštečenja 4. stupnja nisu zabilježena. Postojala je povezanost između stupnjeva o{te}enja i trajanja operacije (p=0,001). Analiza tijekom jednosatnih vremenskih intervala je pokazala da ne postoji odre|eno vrijeme kada nastupa značajno pogoršanje patohistološkog nalaza sluznice crijeva. Zatim su bolesnici podijeljeni u 2 skupine: bolesnici kod kojih su operacije trajale manje od 4 sata i oni kod koji su operacije trajale 4 i vi{e sati. Postojala je statistički zna~ajna razlika u stupnjevima oštečenja sluznice između ovako podijeljenih skupina (p<0,05). Skupina bolesnika kod kojih je operacija trajala manje od 4 sata imala je vi{e uzoraka biopsije crijeva u kojima nije bilo patohistoločkih promjena. Tijekom operacije, u jednosatnim intervalima, uzimani su uzorci krvi iz arterije i mezenterične vene za odre|ivanje pH, koncentracije ugljičnog dioksida i laktata. Razlike u koncentraciji laktata u arterijskoj i mezenteričnoj venskoj krvi nakon 2 i 6 sati postupka između skupine sa i one bez patohistoločkih promjena bile su značajne (p<0,05). Prema tome, za vrijeme anestezije i operacija na otvorenom trbuhu, du`ina postupka utje~e na stupanj oštečenja sluznice tankog crijeva. Pogoršanje patohistoločkih promjena crijevne sluznice povezano je sa visokom razinom laktata u krvi, dokazuju}i tako da je uzrok ovih promjena povezan sa tkivnom hipoksijom.
Keywords (english)
Languageenglish
Publication typeScientific paper - Original scientific paper
Publication statusPublished
Peer reviewPeer review - international
Journal titleCollegium antropologicum
Numberingvol. 35, no. 2, pp. 445-451
p-ISSN0350-6134
URN:NBNurn:nbn:hr:239:105605
Publication2011
Document URLhttps://hrcak.srce.hr/index.php?show=clanak&id_clanak_jezik=103104
Type of resourceText
Access conditionsOpen access
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
Created on2020-02-05 12:39:43