Clinical and Experimental Study of effects of rhubarb on gastrointestinal blood flow perfusion in critical illness

Objective: To investigate the effect of rhubarb on gastrointestinal blood perfusion in critical illness and hemorrhagic shocked rats.Methods: Clinical Study: Sixty four septic patients, who suffered from stress ulcer, were treated with rhubarb at a dose of 25 mg/kg. Twenty five non septic patients were taken as control. The gastrointestinal perfusion was evaluated by intramural pH (pHi). Animal study: SD rats were anesthetized with intraperitoneal sodium pentobarbital at a dose of 20 mg/kg. Blood letting were performed in the animals. Blood pressure reduced to 5.32 kPa and maintained for 120 mins. They were resuscitated at the end of shock by reinfusing all of the shed blood. The rats were randomly divided into four groups: Normal control, shock group, therapeutic group (shocked rats were treated with 50 mg/kg rhubarb at the end of shock) and rhubarb group (normal rats were treated with rhubarb). Laser Doppler was applied to estimate the gastrointestinal blood perfusion. Results: Clinical Study: The gastrointestinal pHi in septic patients was much lower than that in the control, whereas rhubarb could obviously elevate gastrointestinal pHi ( P <0.001). In addition, rhubarb also had good effect on gastric hemorrhage caused by stress ulcer. Animal Study: Although the shocked rats were resuscitated completely, their gastrointestinal blood perfusion was much lower than that in the control. Rhubarb could significantly improve the blood perfusion in gastrointestinal mucosa and mesentery ( P <0.01). Furthermore, rhubarb also increase the gastrointestinal perfusion in normal rats. Conclusion: Rhubarb could improve gastrointestinal blood perfusion in critical illness and shocked rats.