Hemorrhage exacerbates bacterial translocation at low levels of intra-abdominal pressure

Background: It has been shown previously that the adverse cardiopulmonary s equelae of increased intraabdominal pressure (IAP) are worsened by hemorrha ge and resuscitation. Bacterial translocation (BT) to the mesenteric lymph nodes (MLNs), liver, and spleen has also been shown to occur with increased IAP. Objective: To investigate the hypothesis that BT associated with elev ated IAP would be significantly increased after hemorrhage and resuscitatio n. Materials and Methods: Anesthetized adult male rats had femoral artery a nd vein catheters placed, and an intra-abdominal catheter placed to measure IAP. Group 1 underwent surgery only and served as controls. Group 2 had IA P raised to 10 mm Hg by infused lactated Ringer's solution for 40 minutes. Group 3 had a 25% hemorrhage, followed by resuscitation by infused lactated Ringer's solution and shed blood. Group 4 first had a 25% hemorrhage, resu scitated using infused lactated Ringer's solution and shed blood, and then had IAP raised to 10 mm Hg by infused lactated Ringer's solution for 40 min utes. All groups were killed after 2 hours, and had MLNs, liver, and spleen harvested for quantitative cultures. Results: Hemorrhage and resuscitation alone did not increase BT to the MLNs, liver, or spleen. An increase in IA P to 10 mm Hg resulted in a significant level of BT to the MLNs and liver o n MacConkey II agar (P<.05), and a significant increase in the level of BT only to the liver on trypticase soy agar with 5% sheep's blood (P<.05). Hem orrhage and resuscitation did increase the level of BT to the liver and spl een when LAP was increased to 10 mm Hg (P<.05). Conclusions: In this model, hemorrhage and resuscitation alone did not increase BT to the MLNs, liver, or spleen. However, hemorrhage and resuscitation increased BT to the liver and spleen when MP was increased to 10 mm Hg. This supports the concept th at prior hemorrhage and resuscitation exacerbates the effects of increased IAP.