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Evaluation of haemodynamic, metabolic and electrolyte changes after reperfusion in a porcine model of intestinal transplantation

Grant number: 10/06163-0
Support type:Regular Research Grants - Publications - Scientific article
Duration: May 01, 2010 - October 31, 2010
Field of knowledge:Health Sciences - Medicine
Principal Investigator:Alexandre Bakonyi Neto
Grantee:Alexandre Bakonyi Neto
Home Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

To propose an anesthesia protocol in pigs submited to orthotopic small bowel transplantation (SBT) and analysis of intraoperative changes of metabolic, hemodynamic and electrolyte parameters during and after graft reperfusion. Methods: Fiveteen pigs (+/-30Kg) were anestesied by using Acepromazine (0,1mg/kg), morphin (0,4mg/kg), ketamin (10mg/kg) and atropin (0,044mg/kg/IM),followed by induction with diazepam and ketamin (0,1/0,15ml/kg/IV). The maintenance in donors was carried out by xilazin, ketamin and EEG 5% (50mg/ml), diluted in glucose solution at 2,0ml/kg/hour infusion and isofluorane in recipients. Arterial pH, PaCO2, PaO2, BE, HCO3-, SatO2,K,Ca,Na and glucose at T0,T1,T2 and T3 (baseline, before and 10 to 20 minutes post-reperfusion respectively) and HR, PAM, ETCO2, T were measured.Results: The same pattern in hemodynamic and metabolic disorders were observed. Body temperature and PAM decreased in T2 and T3 (GI = 56,2 ± 6,4 e 57,2 ± 8,3mmHg and GII = 65,7 ± 10,2 and 67,8 ± 16,8mmHg, respectivelly),followed by increase HR and ETCO2. A severe metabolic acidosis were observed in T2 and T3, with pH, HCO3 and BE decrease and high PaCO2 in relation to T0 and T1. Levels of K increase significativelly in T2, related to acidosis and graft cellular metabolism, returning to baseline in T3, without variations in Ca++, Na++ ,Hct, Gli, SatO2 between groups. Conclusion: Arterial hypotension followed by severe metabolic acidosis was the haemodynamic and metabolic most important disorder observed after reperfusion respectively, without differences between groups. The proposed protocol used for anesthesia was safe, without intraoperative mortality of the animals. (AU)