THE EFFECT OF INTRAVENOUS VERSUS ENTERAL INFUSIONS OF LIPID EMULSIONS(INTRALIPID) ON BACTERIAL TRANSLOCATION AND IMMUNE FUNCTION IN A RAT MODEL OF RESUSCITATED HEMORRHAGIC-SHOCK AND TRAUMA

This study aimed to elucidate the influence of the route of administra tion of exogenous lipid emulsions (Intralipid, Kabivitrum, Stockholm,S weden) on bacterial translocation and immune suppression in a shocked and resuscitated rat trauma model. Sixty-five male Long-Evans rats wer e divided into three groups, viz. controls, enterally fed and intraven ously fed rats. Experimental rats were traumatized by laparotomy with manipulation of bowel, creation of subcutaneous and femoral catheteriz ation tunnels, and shocked by controlled exsanguination for twenty min utes before resuscitation by reinfusion of shed blood. While the exper imental groups received 20% Intralipid infusions, postoperatively, the control group received standard rat chow and water ad libitum . Lipid infusions were administered at a rate of 70ml/kg/day, either intraven ously via a central line, or enterally, via a gastro-jejunostomy line. Twenty four hours later, at sacrifice, bacterial translocation rates into mesenteric lymph nodes (MLN), blood and organs were studied. In a ddition, mitogen-stimulated lymphocyte transformation rates (LTR), as an index of immune suppression were assessed. The greatest rates of tr anslocation were to the mesenteric lymph nodes, with only insignifican t translocation to peripheral blood, liver and spleen occurring. Both experimental groups showed significantly more translocation than the u ninjured controls (P<0.05), and there was significantly more transloca tion seen in the enteral than in t e parenteral feeding groups (P<0.05 ). In the LTR studies, it could clearly be shown that while suppressio n occurred in the control group, there was significantly less suppress ion in the intravenously fed animals (P<0.05).