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Article: Pathogenesis of neonatal necrotizing enterocolitis: A study of the role of intraluminal pressure, age and bacterial concentration

TitlePathogenesis of neonatal necrotizing enterocolitis: A study of the role of intraluminal pressure, age and bacterial concentration
Authors
Issue Date2003
PublisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00383/index.htm
Citation
Pediatric Surgery International, 2003, v. 19 n. 8, p. 573-577 How to Cite?
AbstractThe pathogenesis of neonatal necrotizing enterocolitis (NEC) is unknown. Intestinal dilatation and preferred occurrence of NEC at sites of bacterial overgrowth (colon and ileum) are common findings. The study attempted to produce NEC with increasing intraluminal pressures and bacterial concentrations in two different aged groups of rats. First, 10-cm terminal ileum segments were isolated with intact vascular pedicles in 1-and 3-month-old rats, and a dose of 1011 E. coli in 1 ml was injected into each segment. Intraluminal pressure was sustained for 1 h at 150, 100, 50 and 0 cmH20, respectively, in four experimental groups (n=6). The isolated loop was then returned to the abdominal cavity and assessed grossly for NEC after 24 h. Histological examination was performed by a pathologist (KWC) who was blinded to the procedures. Second, the procedure was repeated with doses of 108, 10 5 and 0 bacteria/ml (n = 6) at intraluminal pressure of 100 cmH 20 in 1-month-old rats. Third, in another experimental group, oxygenation of the pedicled loop was assessed by oximetry as the intraluminal pressure increased and the findings were correlated with aortic blood pressure. The blood pressures (mean±SD) for 3- and 1-month-old rats were 110 ± 6 and 72±4 mmHg, respectively. Hypoxia (< 50% oxygen saturation) of the bowel was detected when the intraluminal pressure exceeded the mean blood pressure. The relative incidences of NEC in the bowel with intraluminal pressure above and below mean blood pressure were 100% (6/6) vs. 4% (1/24; P<0.05) in 3-month-old rats, and 100% (12/12) vs. 11% (2/18; P<0.05) in 1-month-old rats. There was no occurrence of NEC in bowel injected with 105 E. coli/ml and less at 100 cm intraluminal pressure. Increased intraluminal pressure results in bowel hypoxia and in the presence of adequate bacterial concentration predisposes to the development of NEC. Young age is associated with a lower threshold for increased intraluminal pressure leading to NEC.
Persistent Identifierhttp://hdl.handle.net/10722/88821
ISSN
2015 Impact Factor: 1.01
2015 SCImago Journal Rankings: 0.409
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, KLen_HK
dc.contributor.authorNg, SPen_HK
dc.contributor.authorChan, KWen_HK
dc.contributor.authorWo, YHen_HK
dc.contributor.authorTam, PKHen_HK
dc.date.accessioned2010-09-06T09:48:26Z-
dc.date.available2010-09-06T09:48:26Z-
dc.date.issued2003en_HK
dc.identifier.citationPediatric Surgery International, 2003, v. 19 n. 8, p. 573-577en_HK
dc.identifier.issn0179-0358en_HK
dc.identifier.urihttp://hdl.handle.net/10722/88821-
dc.description.abstractThe pathogenesis of neonatal necrotizing enterocolitis (NEC) is unknown. Intestinal dilatation and preferred occurrence of NEC at sites of bacterial overgrowth (colon and ileum) are common findings. The study attempted to produce NEC with increasing intraluminal pressures and bacterial concentrations in two different aged groups of rats. First, 10-cm terminal ileum segments were isolated with intact vascular pedicles in 1-and 3-month-old rats, and a dose of 1011 E. coli in 1 ml was injected into each segment. Intraluminal pressure was sustained for 1 h at 150, 100, 50 and 0 cmH20, respectively, in four experimental groups (n=6). The isolated loop was then returned to the abdominal cavity and assessed grossly for NEC after 24 h. Histological examination was performed by a pathologist (KWC) who was blinded to the procedures. Second, the procedure was repeated with doses of 108, 10 5 and 0 bacteria/ml (n = 6) at intraluminal pressure of 100 cmH 20 in 1-month-old rats. Third, in another experimental group, oxygenation of the pedicled loop was assessed by oximetry as the intraluminal pressure increased and the findings were correlated with aortic blood pressure. The blood pressures (mean±SD) for 3- and 1-month-old rats were 110 ± 6 and 72±4 mmHg, respectively. Hypoxia (< 50% oxygen saturation) of the bowel was detected when the intraluminal pressure exceeded the mean blood pressure. The relative incidences of NEC in the bowel with intraluminal pressure above and below mean blood pressure were 100% (6/6) vs. 4% (1/24; P<0.05) in 3-month-old rats, and 100% (12/12) vs. 11% (2/18; P<0.05) in 1-month-old rats. There was no occurrence of NEC in bowel injected with 105 E. coli/ml and less at 100 cm intraluminal pressure. Increased intraluminal pressure results in bowel hypoxia and in the presence of adequate bacterial concentration predisposes to the development of NEC. Young age is associated with a lower threshold for increased intraluminal pressure leading to NEC.en_HK
dc.languageengen_HK
dc.publisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00383/index.htmen_HK
dc.relation.ispartofPediatric Surgery Internationalen_HK
dc.subject.meshAge Factorsen_HK
dc.subject.meshAnimalsen_HK
dc.subject.meshEnterocolitis, Necrotizing - etiology - microbiology - physiopathologyen_HK
dc.subject.meshEscherichia coli Infections - complicationsen_HK
dc.subject.meshIleum - physiopathologyen_HK
dc.subject.meshModels, Animalen_HK
dc.subject.meshPressure - adverse effectsen_HK
dc.subject.meshRatsen_HK
dc.subject.meshRats, Sprague-Dawleyen_HK
dc.titlePathogenesis of neonatal necrotizing enterocolitis: A study of the role of intraluminal pressure, age and bacterial concentrationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0179-0358&volume=19&issue=8&spage=573&epage=577&date=2003&atitle=Pathogenesis+of+neonatal+necrotizing+enterocolitis:+a+study+of+the+role+of+intraluminal+pressure,+age+and+bacterial+concentrationen_HK
dc.identifier.emailChan, KW:hrmtckw@hku.hken_HK
dc.identifier.emailTam, PKH:paultam@hkucc.hku.hken_HK
dc.identifier.authorityChan, KW=rp00330en_HK
dc.identifier.authorityTam, PKH=rp00060en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1007/s00383-003-0979-4en_HK
dc.identifier.pmid14551717-
dc.identifier.scopuseid_2-s2.0-0242389673en_HK
dc.identifier.hkuros87998en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0242389673&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume19en_HK
dc.identifier.issue8en_HK
dc.identifier.spage573en_HK
dc.identifier.epage577en_HK
dc.identifier.isiWOS:000186494700002-
dc.publisher.placeGermanyen_HK

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