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Journals / Ulusal Travma ve Acil Cerrahi Dergisi / 2016 / Cilt: 22 - Sayı: 1

Serum fizyolojikle yapılan lavaj sıcaklığının peritoneal fibrinolizve adezyon gelişimine etkisi

Effects of saline lavage temperature on peritoneal fibrinolysis and adhesion formation

Yavuz Savaş KOCA
Ömer Rıdvan TARHAN
SELÇUK KAYA
BERİT GÖKÇE CEYLAN
Pages
1–6
DOI
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⚡ TL;DR(Too Long; Didn't Read)

Hypothermic lavage also caused an inhibition of PAI-1 rise but adhesion, prevention was not significant.CONCLUSION: Our results suggest that normothermic saline lavage reduces adhesions by improving peritoneal fibrinolysis

📌 3 Key Takeaways

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Objective & Hypothesis:BACKGROUND: Peritoneal lavage with saline at room temperature causes peritoneal hypothermia, vasoconstriction, hypoxia, and acidosis, which are effects that are known to reduce fibrinolysis.
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Key Findings & Data:Decreased fibrinolysis causes permanent adhesions.
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Conclusion & Impact:Hypothermic lavage also caused an inhibition of PAI-1 rise but adhesion, prevention was not significant.CONCLUSION: Our results suggest that normothermic saline lavage reduces adhesions by improving peritoneal fibrinolysis
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

BACKGROUND: Peritoneal lavage with saline at room temperature causes peritoneal hypothermia, vasoconstriction, hypoxia, and acidosis, which are effects that are known to reduce fibrinolysis. Decreased fibrinolysis causes permanent adhesions. Normothermic lavage may prevent this deleterious process and reduce peritoneal adhesions.METHODS: A rat model of cecal abrasion was used. Control animals received no medication while hypothermic or normothermic saline lavage were administered intraperitoneally to the experimental groups (n=24 for each group). Cardinal parameters of peritoneal fibrinolysis (tissue plasminogen activator [tPA] and plasminogen activator inhibitor type 1 [PAI-1]) were determined in peritoneal tissue samples on postoperative day 1, 3, and 10. On postoperative day 10, adhesions were graded. In the sham group (n=8), following laparotomy, peritoneal samples were taken to determine basal values of tPA and PAI-1 in healthy peritoneum.RESULTS: Cecal abrasion increased PAI-1 levels about tenfold on postoperative day 1 and caused adhesions. Normothermic saline lavage prevented this traumatic PAI-1 increase and stabilized it to baseline values throughout the experiment and reduced peritoneal adhesion formation. Hypothermic lavage also caused an inhibition of PAI-1 rise but adhesion, prevention was not significant.CONCLUSION: Our results suggest that normothermic saline lavage reduces adhesions by improving peritoneal fibrinolysis

Özet

AMAÇ: Oda sıcaklığındaki serum fizyolojikle yapılan periton lavajı peritonda hipotermi, vazokonstriksiyon, hipoksi ve asidoza neden olur. Bu etki-lerin fibrinolizi azalttığı bilinmektedir. Fibrinolizin bozulması ise kalıcı adezyona neden olmaktadır. Normotermik lavaj bu zararlı süreci engelleyerek peritoneal adezyonları azaltabilir.GEREÇ VE YÖNTEM: Sıçan çekal abrzyon modeli kullanıldı. Kontrol hayvanlarına herhangi bir tedavi uygulanmazken, deney gruplarına (her birinde n=24) hipotermik ve normotermik serum fizyolojik ile lavaj uygulandı. Ameliyat sonrası bir, üç ve onuncu günlerde periton dokusunda peritoneal fibrinolizin ana parametreleri olan doku plazminojen aktivatörü (tPA) ve plazminojen aktivatör inhibitor tip-1 (PAI-1) bakıldı. Adezyonlar ameliyat sonrası 10. günde değerlendirildi. Sham grubunda (n=8) laparotomi sonrası periton örnekleri alındı ve sağlıklı peritondaki bazal tPA ve PAI-1 de-ğerleri tespit edildi.BULGULAR: Çekal abrazyon, PAI-1 düzeylerini ameliyat sonrası birinci günde yaklaşık 10 kat kadar artırarak adezyonlara neden oldu. Normotermik serum fizyolojik ile lavaj bu travmatik PAI-1 artışını engelleyerek deney boyunca normal seviyeye sabitledi ve adezyon gelişimini azalttı. Hipotermik lavaj da PAI-1 yükselişini azalttı ancak adezyonların önlenmesi istatistiksel olarak anlamlı değildi.TARTIŞMA: Sonuçlarımız göstermektedir ki, normotermik serum fizyolojik ile lavaj peritoneal fibrinolizi düzelterek adezyonları azaltmaktadır.Anahtar sözcükler: Hypothermic; normothermic; peritoneal adhesion; peritoneal lavage; plasminogen activator inhibitor 1; saline solution; tissue plasmino-gen activato

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Cite This Article

KOCA, Y. S., TARHAN, Ö. R., KAYA, S., CEYLAN, B. G. (2016). Serum fizyolojikle yapılan lavaj sıcaklığının peritoneal fibrinolizve adezyon gelişimine etkisi. Ulusal Travma ve Acil Cerrahi Dergisi, Cilt: 22 - Sayı: 1, 1–6. https://ajindex.com/articles/323717

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