Objective: To assess the incidence of translocation of enteric bacteria 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.
Material: 96 Adult male Sprague-Dawley rats.
Interventions: Sham operation (n = 24), 70% hepatectomy (n = 36), and 90% hepatectomy (n = 36). Injection of 1 ml (1.5 x 10(7) cpm/rat) 125I-labelled heat-killed Escherichia coli 15 minutes before the animals were killed.
Main Outcome Measures: Arterial blood gas analyses, wet: dry weight ratio of lungs, and measurements of pulmonary isotopic flux (amount of 125I radioactivity in the lungs compared with that in the blood) 1, 2, 4, and 6 hours after operation. Quantitative microbiology of lungs.
Results: There was no pulmonary oedema in those rats that underwent sham operation. Pulmonary oedema had developed by 6 hours after 70% hepatectomy and by 2 hours after 90% hepatectomy. The lung:blood ratio of 125I-labelled bacteria increased as the pulmonary oedema developed, but pulmonary oxygen exchange was not influenced during the first 6 hours after hepatectomy. The incidence of bacterial translocation increased with the extent of hepatectomy and with the length of time after operation.
Conclusion: Bacterial translocation from the gut could lead to pulmonary infection after major liver resection in rats.
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