Prevention of experimental gastric stress bleeding by intravenous hyperalimentation

Clinical gastric stress bleeding (GSB) is associated with a high mortality and morbidity. The purpose of this project was to investigate the effect of intravenous hyperalimentation (IVH) on the incidence of GSB in an experimental model: Sixty adult rats were stressed by immobilization under a wire screen nailed to a board for one hour at 20°C, followed by one hour at 4°C of ambient temperature. During that time, 20 rats received no I.V. solutions, 20 received I.V. normal saline, and 20 received IVH (Freamine II). Both solutions were infused I.V. at a rate of 1.45/ml/100 gms/body weight/hour. At the end of the 2 hours, the rats were decapitated, their stomachs were removed, opened and photographed. The number of ulcers was counted on the specimen by an observer not aware of the protocol. In the control immobilized rats, 15 ± S.D. ulcers were counted. In those immobilized receiving I.V. N/S, 16 ± 3 S.D. ulcers were counted. In contrast, in those immobilized receiving IVH, 4 ± 2 S.D. ulcers were counted. The difference between those receiving IVH and the other two groups (controls) was highly significant, P<.001. Hyperalimentation did not change the output of acid PH of pepsin in Pavlov and Heidenheim pouches performed in dogs. The progression of the lesion observed in animals sacrified serially was that of a mucosal capillary hemorrhage progressing into mucosal ulcerations. These results demonstrate that under our experimental conditions, IVH can significantly diminish the incidence of gastric stress bleeding. They also suggest that the measured gastric secretory factors may have no role in the pathogenesis of these erosions.