Peritoneal instillation of taurolidine or polihexanide modulates intestinal microcirculation in experimental endotoxemia

Background and aimsTreatment of peritonitis may include peritoneal lavage/instillation with anti-infective agents like taurolidine or chlorhexidine.Materials and methodsWe examined the effects of peritoneal instillation (INST, 5-ml solution) with taurolidine (TAURO) or polihexanide (POLI-LS) on intestinal microcirculation using intravital microscopy (IVM) in experimental endotoxemia (15 mg/kg lipopolysaccharide i.v.; LPS) in the rat (n = 8 each group), their direct effects on local small blood vessels, aortal rings, and myocardial strips in vitro, as well as plasma interleukin levels.ResultsIt was found that LPS produced hypotension (98.8 ± 9.5 vs 130.4 ± 10.5 mmHg; mean arterial pressure [MAP], mean ± standard deviation [SD]), which was further pronounced after INST of TAURO (78.8 ± 10.8; P < 0.005) or POLI-LS (78.1 ± 6.0; P < 0.001). IVM revealed a reduction in temporary adhering leucocytes and an increase in firmly adhering leucocytes after INST with TAURO and POLI-LS. Both agents reduced functional capillary density either in the mucosa (POLI-LS vs sham: 259.7 ± 54 cm/cm2 vs 337.1 ± 35.5) or longitudinal muscular layer in LPS rats (TAURO vs sham: 119.8 ± 14.8 vs 153.7 ± 11.0). POLI-LS induced local vasodilatation, whereas TAURO induced small vasoconstriction; in vitro, both agents showed vasodilating properties and did not have any effect on myocardial strip contraction.ConclusionSome of the observed microcirculatory changes could be a result of the direct vascular effects of these agents.