Meng-Tse Gabriel Lee1, Chien-Chang Lee1,2,3, Hsuan-Mao Wang1, Tzung-Hsin Chou1, Meng-Che Wu1, Kuang-Lung Hsueh4, Shyr-Chyr Chen1. 1. Department of Emergency Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. 2. Department of Emergency Medicine, National Taiwan University Hospital Yunlin Branch, Douliou, Taiwan. 3. Department of General Medicine, National Taiwan University Hospital Yunlin Branch, Douliou, Taiwan. 4. Research Department, China Medical University Hospital, Research Center for Tumor Medical Science, and Center for Chinese medicine and acupuncture, China Medical University, Taichung, Taiwan.
Abstract
BACKGROUND: Therapeutic hypothermia during operation decreases postoperative intra-abdominal adhesion formation. We sought to determine the most appropriate duration of hypothermia, and whether hypothermia affects the expression of tissue plasminogen activator (tPA). METHODS: 80 male BALB/c mice weighing 25-30 g are randomized into one of five groups: adhesion model with infusion of 15°C saline for 15 minutes (A); 30 minutes (B); 45 minute (C); adhesion model without infusion of cold saline (D); and sham operation without infusion of cold saline (E). Adhesion scores and tPA levels in the peritoneum fluid levels were analyzed on postoperative days 1, 7, and 14. RESULTS: On day 14, the cold saline infusion groups (A, B, and C) had lower adhesion scores than the without infusion of cold saline group (D). However, only group B (cold saline infusion for 30 minutes) had a significantly lower adhesion scores than group D. Also, group B was found to have 3.4 fold, 2.3 fold, and 2.2 fold higher levels of tPA than group D on days 1, 7, and 14 respectively. CONCLUSIONS: Our results suggest that cold saline infusion for 30 minutes was the optimum duration to decrease postoperative intra-abdominal adhesion formation. The decrease in the adhesion formations could be partly due to an increase in the level of tPA.
BACKGROUND: Therapeutic hypothermia during operation decreases postoperative intra-abdominal adhesion formation. We sought to determine the most appropriate duration of hypothermia, and whether hypothermia affects the expression of tissue plasminogen activator (tPA). METHODS: 80 male BALB/c mice weighing 25-30 g are randomized into one of five groups: adhesion model with infusion of 15°C saline for 15 minutes (A); 30 minutes (B); 45 minute (C); adhesion model without infusion of cold saline (D); and sham operation without infusion of cold saline (E). Adhesion scores and tPA levels in the peritoneum fluid levels were analyzed on postoperative days 1, 7, and 14. RESULTS: On day 14, the cold saline infusion groups (A, B, and C) had lower adhesion scores than the without infusion of cold saline group (D). However, only group B (cold saline infusion for 30 minutes) had a significantly lower adhesion scores than group D. Also, group B was found to have 3.4 fold, 2.3 fold, and 2.2 fold higher levels of tPA than group D on days 1, 7, and 14 respectively. CONCLUSIONS: Our results suggest that cold saline infusion for 30 minutes was the optimum duration to decrease postoperative intra-abdominal adhesion formation. The decrease in the adhesion formations could be partly due to an increase in the level of tPA.
Authors: Richard P G Ten Broek; Martijn W J Stommel; Chema Strik; Cornelis J H M van Laarhoven; Frederik Keus; Harry van Goor Journal: Lancet Date: 2013-09-27 Impact factor: 79.321