Bacterial translocation induces proinflammatory responses and is associated with early death in experimental severe injury

Objective: An experimental model of severe injury with great lethality was studied to define the impact of bacterial translocation on survival and on inflammatory response. Methods: Forty-one rabbits were divided into two groups: A, femur myotomy; and B, myotomy and fracture of the femoral bone. Vital signs and survival were recorded. Serum circulating endotoxins (lipopolysaccharides; LPS) were determined and tissue cultures were performed at necropsy. A subgroup of animals was sacrificed at 48 h post injury; LPS was determined in abdominal aorta and portal vein, apoptosis of spleen cells was assessed by flow cytometry, and ex vivo production of tumor necrosis factor alpha by splenocytes was measured. Results: Tissue bacterial burden was increased in animals that died early (i.e., within 48 h after injury) versus rabbits that died later. Portal vein LPS at 48 h was increased in group B compared with group A, whereas circulating LPS did not differ. No difference in apoptosis of either lymphocytes or macrophages of the spleen was found in group B compared with group A. Following stimulation with LPS or phytohemagglutinin, tumor necrosis factor a production by splenocytes of group B was greater than that of group A. Conclusions: Bacterial translocation primes enhanced proinflammatory responses and it is associated with early death in severe trauma. (C) 2013 Elsevier Inc. All rights reserved