Experimental study to investigate the damaging effects of total parental nutrition technique on vascular endothelial ceels

11. SUMMARYTotal parenteral nutrition (TPN) technique is used to give the vitally mandatorysubstrates, such as water, proteins, carbohydrates, lipids, electrolytes, vitamins and the traceelements, into the peripheral or the central compartments, whenever the gastrointestinalsystem can not be used by the patient. The mortality of surgical procedures has decreased ata significant extent by the widespread use of TPN.On the other hand complications resulting from the TPN technique have appearedas an important cause of mortality. Among these complications hepatobiliary dysfunctionsand the sepsis are the most emphasized ones and there are a lot of investigations madeabout them.Etiopathogenesis of sepsis due to TPN has not been totally clarified yet. Theresearches made in this matter, accused catheters and solutions or emulsions are given.Other possible reason is the endothelial damage caused by the TPN practice.In this experimental study we have planned to investigate vascular endothelial celldamage, due to its key role in the evolution of TPN technique related sepsis.In this study we used a number of 50 rabbits, divided into 5 groups. Each group hasten rabbits. For the preceding four groups central venous catheters are applied by the ?cut-down? method to the internal jugular vein.TPN with lipid was given for 10 days to the first group. Second group received aTPN without lipid content for 10 days. The third group received only 0.09% saline. Fourthgroup did not get any applications besides they had central venous catheters and arefollowed up for 10 days. And finally the fifth group was kept as a control group.At the end of the period of 10 days, rabbits are sacrificed and the tissue samples ofliver, kidney and vena cava inferior are taken.60VCAM-1 expression, which is a marker for the endothelial cell damage, is lookedfor in the taken samples, by immunohistochemical methods. Statistical matches of theresults are made by the LSD and the ANOVA tests.As the all results are evaluated, we determined that; TPN technique results in anendothelial cell damage in small veins of the liver and the kidney tissue, and the inferiorvena cava, and this damage results from the contents of the TPN solutions, and the lipidcontents found in these solutions decreases this damage even if it is not statisticallysignificant.As a conclusion we believed that; vascular endothelial cell damage, having a keyrole in the evolution of sepsis as a complication of TPN, is caused by the contents of theTPN solutions and this damage can be lessened by adjoining the lipids to these solutions.61