Treatment of Ischemic Equine Jejunum with Topical and Intraluminal Carolina Rinse

Carolina Rinse (CRS) has been shown to be effective in decreasing vascular permeability and neutrophil infiltration in reperfused equine small intestine. The objective of this study was to show that CRS applied topically and intraluminally could prevent immediate reperfusion injury after low flow ischemia or distention in the equine jejunum.

Materials & Methods: Two groups of 5 horses were used to evaluate CRS treatment after low-flow ischemia (Group 1) and intraluminal distention (Group 2) of distal jejunum. Mesenteric blood flow, osmotic reflection coefficient (ORC), wet weight to dry weight ratios (WW/DW), and neutrophil accumulation in the serosa were measured. ORC is defined as the lymph protein concentration to plasma protein concentration ratio subtracted from one (1- Cl / Cp) at maximal lymph flow. The ORC from baseline values and at 60 minutes after initiating reperfusion was compared between Groups 1 and 2. Pair wise comparisons were made for mesenteric blood flow, tissue volume, neutrophil number, and WW/DW proximal control and CRS treated jejunal segments were made using a Mann Whitney U test (P< 0.05).

Results: The mean ORC of bowel treated topically and intraluminally with CRS was similar to that recorded in normal bowel or ischemic intestine treated with CRS by arterial perfusion. The ORC after distention and decompression increased and was similar to that reported in untreated intestine. The WW/DW after both ischemia and distention increased compared to the proximal control segments. There was no difference in neutrophil number in either ischemic or distended intestine compared to the proximal control segments.

Discussion: Carolina CRS was effective in preventing alterations in microvascular permeability during reperfusion afterischemia but not distention. Neutrophil migration curtailed in both groups suggesting that combined topical and intraluminal application of CRS to ischemic intestine may reduce the acute inflammatory responses during reperfusion thereby decreasing complications after ischemia or distention.