Faculty Collaboration Database

Shock associated with endothelial dysfunction in omental microvessels. Eur J Clin Invest 2017 Jan;47(1):30-37

Date

11/04/2016

Pubmed ID

27809354

DOI

10.1111/eci.12697

Scopus ID

2-s2.0-85006683123 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

BACKGROUND: Impaired microvascular function leads to a poor outcome in a variety of medical conditions. Our aim was to determine whether vasodilator responses to acetylcholine (Ach) are impaired in human omental arterioles from patients with severe trauma.

MATERIALS AND METHODS: Patients with massive blood loss and severe shock requiring damage control procedures were included. Tissues were collected at the first (FEL) and the second explorative laparotomy (SEL). Control tissues were collected from nontrauma patients. Freshly isolated 50-200-μm-diameter omental arterioles were analysed using videomicroscopy. Dihydroethidine and DCF-DA fluorescence were used to assess reactive oxygen species (ROS) production. MnTBAP was used to determine the contribution of excess vascular superoxide contribution to endothelial dysfunction.

RESULTS: After constriction (30-50%) with endothelin-1, dilation to graded doses of Ach (10^-9 -10^-4 M) was greater in control vessels compared to FEL and SEL (max dilation at 10^-4 M (MD) = 25 ± 3%, n = 8; and 59 ± 8%, n = 8, respectively, and controls MD = 93 ± 10%, n = 6, P < 0·05). Fluorescence imaging of ROS production showed significant increases in superoxide (225·46 ± 12·86; 215·77 ± 10·75 vs. 133·75 ± 7·26, arbitrary units; P < 0·05) and peroxide-related ROS (240·8 ± 20·42; 234·59 ± 28·86, vs. 150·78 ± 15·65, arbitrary units; P < 0·05), in FEL and SEL microvessels compared to control, respectively. FEL pretreated with MnTBAP demonstrated significant improvement in Ach-induced vasodilation (25·5 ± 3·0% vs. 79·5 ± 8·2%; P < 0·05).

CONCLUSIONS: Severe shock associated with microvascular endothelial dysfunction enhances production of ROS in human omental tissues. The altered flow regulation may contribute to a mismatch between local blood supply and demand, exacerbating abnormal tissue perfusion and function.

Author List

Somberg LB, Gutterman DD, Miura H, Nirula R, Hatoum OA

MESH terms used to index this publication - Major topics in bold

Acetylcholine
Adolescent
Adult
Aged
Aged, 80 and over
Arterioles
Case-Control Studies
Child
Endothelin-1
Endothelium, Vascular
Female
Humans
In Vitro Techniques
Male
Microvessels
Middle Aged
Omentum
Reactive Oxygen Species
Shock, Hemorrhagic
Vasodilation
Vasodilator Agents
Wounds and Injuries
Young Adult