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proLékaře.cz / Journals / Perspectives in Surgery / 2021 - 1

Danger of bacterial translocation for a surgical patient

Czech version

Authors: E. Havel
Authors‘ workplace: Chirurgická klinika Fakultní nemocnice Hradec Králové a Lékařská fakulta v Hradci Králové Univerzity Karlovy
Published in: Rozhl. Chir., 2021, roč. 100, č. 1, s. 4-9.
Category: Review
doi: https://doi.org/10.33699/PIS.2021.100.1.4–9

Overview

Intestinal barrier disorder manifestation occurs in connection with surgery in conditions of shock ischemia-reperfusion of the intestine or deterioration of an already damaged barrier due to chronic disease. The result is infectious complications caused by the transport of pathogens through the venous blood, most often postoperative pneumonia and sepsis. However, a more frequent manifestation is the intensification of the postoperative systemic inflammatory response through the lymphatic transport of toxic substances, inanimate antigens and cytokines through the lymphatic system of the splanchnic area (gut-lymph axis). The problem can affect up to half of patients with abdominal surgery. Preventive measures consist of strengthening the intestinal barrier before surgery and alleviating the loss of the intestinal barrier in the perioperative period. In the treatment of infectious complications, an early recognition indication for the therapeutic administration of antibiotics based on preoperative microbial screening of patients at risk may help.

Keywords:

intestinal barrier − bacterial translocation− intestinal permeability − antibiotic prophylaxis − abdominal surgery

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