EFFECTS OF A WATER-SOLUBLE ETHYLHYDROXYETHYL CELLULOSE ON GUT PHYSIOLOGY, BACTERIOLOGY, AND BACTERIAL TRANSLOCATION IN ACUTE LIVER-FAILURE

Bacterial infection and bacteremia are common complications in patient s with acute liver failure. Bacterial translocation from the gut has b een suggested to be a major cause of bacterial infections in experimen tal acute liver failure. In the present study, a water-soluble ethylhy droxyethyl cellulose (EHEC) was administrated orally 1 and 24 hours pr ior to 90% hepatectomy in the rat in order to prevent bacterial transl ocation in experimental acute liver failure induced by subtotal liver resection in the rat. Ninety percent hepatectomy alone resulted in 80 to 100% translocation to mesenteric lymph nodes or blood 2 and 4 hours after operation. There was no translocation in rats undergoing sham o peration or 90% hepatectomy with EHEC administration prior to operatio n (p <.01), Bacterial overgrowth, increased bacterial adherence onto t he intestinal surface, and diminished intestinal and mucosal mass were also observed in animals with subtotal liver resection, but not in th ose administered EHEC. A delayed 2-hour intestinal transit time occurr ed in both groups receiving subtotal liver resection, with or without oral EHEC. EHEC inhibited bacterial growth and DNA synthesis and alter ed bacterial surface properties after 1-hour incubation with bacteria in vitro, an interaction that was not further influenced by time. Thes e results imply that EHEC may alter enterobacterial capacities of meta bolism, proliferation, and invasion by effects on the bacterial surfac e. Furthermore, EHEC seems to possess a trophic action on the intestin e, though without enhancing the intestinal motility.