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Intensive Care Med (2011) 37:15341542DOI 10.1007/s00134-011-2267-4 EXPERIMENTAL
Matthieu Legrand Rick Bezemer Asli Kandil Cihan Demirci Didier PayenCan Ince
The role of renal hypoperfusion in development of renal microcirculatory dysfunctionin endotoxemic rats
Received: 19 January 2011 Accepted: 7 May 2011Published online: 22 June 2011 The Author(s) 2011. This article is published with open access at Springerlink.com
M. Legrand and R. Bezemer contributed equally to this work.
Electronic supplementary materialThe online version of this article (doi:http://dx.doi.org/10.1007/s00134-011-2267-4
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M. Legrand R. Bezemer
A. Kandil C. Ince
Department of Translational Physiology, Academic Medical Center,University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
M. Legrand ()) D. Payen
Department of Anesthesiology and Critical Care, Lariboisire Hospital,Assistance Publique-Hopitaux de Paris, University of Paris 7 Denis Diderot,2 rue Ambroise-Par,75475 Paris Cedex 10, Francee-mail: [email protected] Tel.: ?33-1-49958085Fax: ?33-1-49958073
A. Kandil C. Demirci
Faculty of Science, Department of Biology, Istanbul University, 34459 Vezneciler, Istanbul, Turkey
Abstract Purpose: To study the role of renal hypoperfusion in development of renal microcirculatory dysfunction in endotoxemic rats. Methods: Rats were randomized into four groups: a sham group(n = 6), a lipopolysaccharide (LPS) group (n = 6), a group in which LPS administration was followed by immediate uid resuscitation which prevented the drop of renal blood ow (EARLY group) (n = 6), and a group in which LPS administration was followed by delayed (i.e., a 2-h delay) uid resuscitation (LATE group) (n = 6). Renal blood ow was measured using a transit-time ultra-sound ow probe. Microvascular perfusion and oxygenation distributions in the renal cortex were assessed using laser speckle imaging and phosphorimetry, respectively. Inter-leukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-a were measured as markers of systemic inammation. Furthermore, renal tissue samples were stained for leukocyte inltration and inducible nitric oxide synthase (iNOS) expression in the kidney. Results: LPS infusion worsened both microvascular perfusion and oxygenation distributions. Fluid resuscitation
improved perfusion histograms but not oxygenation histograms. Improvement of microvascular per-fusion was more pronounced in the EARLY group compared with the LATE group. Serum cytokine levels decreased in the resuscitated groups, with no difference between the EARLY and LATE groups. However, iNOS expression and leukocyte inltration in glomeruli were lower in the EARLY group compared with...