In vitro evaluation of a customized solution for use in attenuating effects of ischemia and reperfusion in the equine small intestine

Objective-To determine whether a customized solution could attenuate the effects of low-flow ischemia and reperfusion injury of the equine jejunum. Sample Population-A segment of jejunum obtained from 21 healthy adult horses. Procedure-A segment of jejunum was maintained in an isolated extracorporeal circuit, and arterial flow was reduced to 20% of baseline for 40 minutes (ischemia) followed by 60 minutes of reperfusion. In 1 group, a customized solution was infused at a rate of 1 ml/min during low-flow ischemia and 3 ml/min during reperfusion. In a second group, the solution was infused at the same rate during low-flow ischemia, but it was infused at a rate of 7 ml/min during reperfusion. Control groups received lactated Ringer's solution administered at the same rates as for the customized solution. Various metabolic, hemodynamic, histologic, and permeability variables were recorded. Results-A lower flow rate during reperfusion (3 ml/min) had a beneficial effect, compared with lactated Ringer's solution or the higher flow rate (7 ml/min). Use of the solution at this rate resulted in less histomorphologic injury and reduced mucosal permeability to albumin. Conclusions and Clinical Relevance-Use of a customized solution at a lower flow rate during reperfusion appeared to have a protective effect on equine jejunum when administered IV during low-flow ischemia and reperfusion.