PULMONARY INFECTIONS OF GUT ORIGIN AFTER MAJOR LIVER RESECTION IN RATS

Objective: To assess the incidence of translocation of enteric bacteri a to the lungs in the early postoperative period (1, 2, 4, and 6 hours ) after sham operation, 70% hepatectomy, and 90% hepatectomy. Design: Randomised laboratory experiment. Setting: University department. Mate rial: 96 Adult male Sprague-Dawley rats. Interventions: Sham operation (n = 24), 70% hepatectomy (n = 36), and 90% hepatectomy (n = 36). Inj ection of 1 ml (1.5 x 10(7) cpm/rat) I-125-labelled heat-killed Escher ichia coli 15 minutes before the animals were killed. Main outcome mea sures: Arterial blood gas analyses, wet:dry weight ratio of lungs, and measurements of pulmonary isotopic flux (amount of I-125 radioactivit y in the lungs compared with that in the blood) 1, 2, 4, and 6 hours a fter operation. Quantitative microbiology of lungs. Results: There was no pulmonary oedema in those rats that underwent sham operation. Pulm onary oedema had developed by 6 hours after 70% hepatectomy and by 2 h ours after 90% hepatectomy. The lung:blood ratio of I-125-labelled bac teria increased as the pulmonary oedema developed, but pulmonary oxyge n exchange was not influenced during the first 6 hours after hepatecto my. The incidence of bacterial translocation increased with the extent of hepatectomy and with the length of time after operation. Conclusio n: Bacterial translocation from the gut could lead to pulmonary infect ion after major liver resection in rats.