Comparação entre o TRIS, Lactose/TRIS, Ringer-Lactato e Leite Desnatado como diluidores na criopreservação do sêmen bubalino

O objetivo do experimento foi testar a eficácia de diferentes diluidores, a base de Ringer-Lactato, Leite Desnatado, TRIS (hidroxi-methil-amino-methan) e Lactose/TRIS, na criopreservação de sêmen bubalino. Foram utilizados três machos bubalinos da raça Murrah em plena atividade sexual. O sêmen foi colhido por vagina artificial totalizando 71 ejaculados. Após a colheita, cada amostra foi submetida às análises qualitativas e quantitativas do sêmen. Os ejaculados foram fracionados e diluídos nos quatro diluidores. O sêmen diluído foi envasado em palhetas de 0,25ml e submetidos a um tempo de equilíbrio de até quatro horas a 5ºC, com posterior congelação em nitrogênio líquido. As amostras identificadas foram descongeladas em banho maria à temperatura de 40°C por 30 segundos e seqüencialmente avaliadas quanto a motilidade, vigor, lesão de acrossoma, e percentual de patologias espermáticas. As amostras também foram submetidas ao teste de termo-resistência, permanecendo incubadas à temperatura de 40°C durante 30 segundos, 3-5 minutos, 30 minutos, 1 hora, 2 horas e 3 horas, onde foram avaliadas quanto a motilidade e o vigor espermático. As características físicoquímicas, após análise do sêmen in natura, encontraram-se dentro dos valores preconizados para a espécie bubalina e satisfatórios para o processo de congelação. Após descongelação do sêmen, observou redução numérica estatística (p<0,05) na motilidade espermática, sendo que no sêmen in natura se observou 86,67±6,17% reduzindo para 70±6,92% em TRIS, 67,4±8,01% em Ringer/lactato, 67,09±9,03% em Lactose/TRIS e 59,7±9,05% em leite desnatado e ao comparar entre os quatro tratamentos apenas o Leite desnatado mostrou diferença estatística significativa (p<0,05). Após descongelação, o vigor espermático também diminuiu estatisticamente (p<0,05) nos quatro tratamentos (3,50±0,53 TRIS; 3,38±0,49 Ringer-lactato; 3,3±0,46 Lactose/TRIS e 3,25±0,44 Leite desnatado) versus (4±0,39 sêmen in natura) e ao comparar entre os tratamento, apenas entre Leite desnatado e TRIS se observou diferença estatística (p<0,05). Quanto aos defeitos maiores (4,15±1,9% sêmen in natura; 10,51±4,4% TRIS; 11,94±4,2% Ringer-Lactato; 11,88±4,8% Lactose/TRIS; 12,01±5% Leite desnatado), menores (3,81±1,2% sêmen in natura; 4,67±1,1% TRIS; 4,98±1,7% Ringer-Lactato; 4,93±2,0% Lactose/TRIS; 4,93±2,0% Leite desnatado) e totais (7,91±2,1% sêmen in natura; 15,18±4,7% TRIS; 16,92±4,8% Ringer-Lactato; 16,82±5,6% Lactose/TRIS; 17,11±5,6% Leite desnatado), após descongelação houve aumento significativo dos defeitos nos quatro tratamentos (p<0,05), e entre eles não foram observadas diferenças estatísticas entre si (p>0,05). Na fase pós-TTR, após 3 horas de incubação, a motilidade progressiva (TRIS 21,13±7,5%; Ringer-Lactato 20,78±7,4%; Lactose/TRIS 20,25±5,3%; Leite desnatado 20,12±6,6%) e vigor espermático (TRIS 2,04±0,5; Ringer-Lactato 2,07±0,5; Lactose/TRIS 2,02±0,4; Leite desnatado 2,00±0,5) não apresentaram diferença estatística entre os tratamentos (p<0,05). Quanto a intergridade do acrossoma, após a descongelação (Sêmen in natura 97,85±0,6%; TRIS 91,65±4,3%; Ringer-Lactato 90,46±4,8%; Lactose/TRIS 89,76±5,4%; Leite desnatado 90,56±5,6%), houve diminuição estatística (p<0,05) e quando se comparou tal parâmetro entre os tratamentos não foi observado diferenças estatísticas significativas entre os tratamento (p>0,05). Diante dos resultados observados é possível concluir que a congelação de sêmen de búfalo com os diluidores TRIS (Trishydroxy- methyl-amino-methan), Ringer-Lactato, Lactose/TRIS, e Leite desnatado mostraram satisfatória função de crioproteção na viabilidade espermática do sêmen nas diferentes etapas da criopreservação.

Estudo eletroquímico comparativo do aço ISO 5832-9 em diferentes meios de interesse biológico

Foi estudado o comportamento eletroquímico a 37°C do aço inoxidável ISO 5832-9, em meios de NaCl 0,9 %, de Ringer Lactato e meio mínimo de Eagle (MEM), por voltametria linear e análises da superfície por microscopia eletrônica de varredura (MEV) e por espectroscopia por dispersão de energia (EDS). Foram feitos ensaios mecânicos e testes de toxicidade. O aço ISO 5832-9 se encontra passivado no potencial de corrosão e não apresenta corrosão por pite nos três meios estudados em toda faixa de potencial investigada, desde o potencial de corrosão até 50 mV acima do potencial de transpassivação. Em meio de MEM, no entanto, as análises por MEV e EDS mostraram que o referido aço, nesse valor mais elevado de potencial, apresentou um comportamento diferente, com perda das inclusões de óxido de manganês. Os potenciais de corrosão, Ecorr (potencial de circuito aberto estacionário) bem como os valores de densidade de corrente de passivação, variaram na seguinte ordem: Ecorr, RL < Ecorr, NaCl < Ecorr, MEM. e jMEM << jRL ≅ jNaCl. No ensaio de citotoxicidade, o aço foi caracterizado como não-tóxico.

A peptide inhibitor of C-jun N-terminal kinase modulates hepatic damage and the inflammatory response after hemorrhagic shock and resuscitation

Hemorrhage and resuscitation (H/R) leads to phosphorylation of mitogen-activated stress kinases, an event that is associated with organ damage. Recently, a specific, cell-penetrating, protease-resistant inhibitory peptide of the mitogen-activated protein kinase c-JUN N-terminal kinase (JNK) was developed (D-JNKI-1). Here, using this peptide, we tested if inhibition of JNK protects against organ damage after H/R. Male Sprague-Dawley rats were treated with D-JNKI-1 (11 mg/kg, i.p.) or vehicle. Thirty minutes later, rats were hemorrhaged for 1 h to a MAP of 30 to 35 mmHg and then resuscitated with 60% of the shed blood and twice the shed blood volume as Ringer lactate. Tissues were harvested 2 h later. ANOVA with Tukey post hoc analysis or Kruskal-Wallis ANOVA on ranks, P < 0.05, was considered significant. c-JUN N-terminal kinase inhibition decreased serum alanine aminotransferase activity as a marker of liver injury by 70%, serum creatine kinase activity by 67%, and serum lactate dehydrogenase activity by 60% as compared with vehicle treatment. The histological tissue damage observed was blunted after D-JNKI-1 pretreatment both for necrotic and apoptotic cell death. Hepatic leukocyte infiltration and serum IL-6 levels were largely diminished after D-JNKI-1 pretreatment. The extent of oxidative stress as evaluated by immunohistochemical detection of 4-hydroxynonenal was largely abrogated after JNK inhibition. After JNK inhibition, activation of cJUN after H/R was also reduced. Hemorrhage and resuscitation induces a systemic inflammatory response and leads to end-organ damage. These changes are mediated, at least in part, by JNK. Therefore, JNK inhibition deserves further evaluation as a potential treatment option in patients after resuscitated blood loss.

Avaliação da resistência à corrosão de implantes em aços inoxidáveis ISO 5832-9 e F138 removidos de pacientes

This work has compared the surfaces of two different steel samples used as orthopedical implants, classified as ASTM F138 and ISO5832-9, through optical emission spectroscopy, by means of SEM and EDS. The samples (implants) were also submitted to potentiodynamic cyclic polarization in Ringer lactate and NaCl 0.9 M L-1 solutions; ISO5832-9 sample did not show any kind of localized corrosion, but in the case of F138 steel was observed a pit localized corrosion in both solutions. In Ringer lactate solution it was observed a loss of about 63% for nickel and 26% for iron for F138 stell, compared to the initial composition.

Variations in gastric compliance induced by acute blood volume changes in anesthetized rats

The impact of acute volume imbalances on gastric volume (GV) was studied in anesthetized rats (250-300 g). After cervical and femoral vessel cannulation, a balloon catheter was positioned in the proximal stomach. The opposite end of the catheter was connected to a barostat with an electronic sensor coupled to a plethysmometer. A standard ionic solution was used to fill the balloon (about 3.0 ml) and the communicating vessel system, and to raise the reservoir liquid level 4 cm above the animals' xiphoid appendix. Due to constant barostat pressure, GV values were considered to represent the gastric compliance index. All animals were monitored for 90 min. After a basal interval, they were randomly assigned to normovolemic, hypervolemic, hypovolemic or restored protocols. Data were compared by ANOVA followed by Bonferroni's test. Mean arterial pressure (MAP), central venous pressure (CVP) and GV values did not change in normovolemic animals (N = 5). Hypervolemic animals (N = 12) were transfused at 0.5 ml/min with a suspension of red blood cells in Ringer-lactate solution with albumin (12.5 ml/kg), which reduced GV values by 11.3% (P<0.05). Hypovolemic rats (N = 12) were bled up to 10 ml/kg, a procedure that increased GV values by 15.8% (P<0.05). In the restored group (N = 12), shed blood replacement brought GV values back to basal levels in bled animals (P>0.05). MAP and CVP values increased (P<0.05) after hypervolemia but decreased (P<0.05) with hypovolemia. In conclusion, blood volume level modulates gastric compliance, turning the stomach into an adjustable reservoir, which could be part of the homeostatic process to balance blood volume.

Evaluation of hemostatic changes using thromboelastography after crystalloid or colloid fluid administration during major orthopedic surgery

The effects of Ringer lactate, 6% hydroxyethyl starch (HES) (130/0.4) or 4% succinylated gelatin solutions on perioperative coagulability were measured by thromboelastography (TEG). Seventy-five patients (ASA I-III) who were to undergo major orthopedic procedures performed under epidural anesthesia were included in the study. Patients were randomly divided into three groups of 25 each for the administration of maintenance fluids: group RL (Ringer lactate), group HES (6% HES 130/0.4), and group JEL (4% gelofusine solution). Blood samples were obtained during the perioperative period before epidural anesthesia (t1, baseline), at the end of the surgery (t2), and 24 h after the operation (t3). TEG data, reaction time (R), coagulation time (K), angle value (α), and maximum amplitude (MA) were recorded. TEG parameters changed from normal values in all patients. In group RL, R and K times decreased compared to perioperative values while the α angle and MA increased (P < 0.05). In group HES, R and K times increased, however, the α angle and MA decreased (P < 0.05). In group JEL, R time increased (P < 0.05), but K time, α angle and MA did not change significantly. In the present study, RL, 6% HES (130/0.4) and 4% JEL solutions caused changes in the coagulation system of all patients as measured by TEG, but these changes remained within normal limits.

Comparative electrochemical study of 5832-9 stainless steel at different media of biological interest

The electrochemical behavior of ISO 5832-9 stainless steel at 37 degrees C in 0.9% NaCl, Ringer Lactate and minimum essential medium (MEM) has been studied, using linear voltammetry, and surface analysis by SEM and EDS. Mechanical and toxicity tests were made. ISO 5832-9 is passivated at corrosion potential (E) and it does not present pitting corrosion on the media studied from to 50 in V above the transpassivation potential (Ei). SEM and EDS analysis have shown that the sample previously immersed in MEM presents a diffirent behavior at 50 in V above El: the manganese oxide inclusions are absent in the surface. E. values and passivation current density values j(pass) changed according to the following. E(corr, RL) < E(corr,NaCl) < E(corr, MEM) and J (MEM) << j(RL) congruent to j(NaCl) The stainless steel was characterized as non toxic in the cytotoxicity assay

Prevenção de aderências pélvicas: estudo experimental em ratas com diferentes modalidades terapêuticas

OBJETIVOS: avaliar o grau de aderências pélvicas em função do tempo e da utilização de diferentes substâncias empregadas na sua profilaxia. MATERIAL E MÉTODOS: estudo prospectivo com 120 ratas Wistar, albinas, virgens, 3 a 4 meses de idade, pesando aproximadamente 250 gramas, divididas aleatoriamente em 10 grupos de 12 animais cada: controle, sem lesão; lesões e sem tratamento; lesões + solução fisiológica 0,9%; lesões + Ringer-lactato; lesões + dextrano 70 a 32%; lesões + Ringer-lactato/heparina; lesões + Ringer-lactato/dexametasona; lesões + Ringer-lactato/hidrocortisona/dexametasona/ampicilina; lesões + Ringer-lactato/albumina e lesões + carboximetilcelulose 1%. Após anestesiados os animais, realizaram-se dois tipos de lesões nos cornos uterinos (escarificação e eletrocauterização), seguidos de tratamento profilático intraperitoneal com as soluções citadas. No 7º, 14º e 28º dia pós-operatório, momentos M1, M2 e M3, respectivamente, avaliaram-se quatro ratas de cada grupo quanto à presença de aderências. Os métodos empregados na quantificação das aderências encontradas basearam-se na classificação de Cohen, com escores variando de 0 a 4+ de acordo com a quantidade, características e localização das aderências. Foram usadas provas paramétricas para análise da variância e Kruskal-Wallis. RESULTADOS: os melhores tratamentos para prevenção de aderência pélvica em ratas foram: Ringer-lactato/dexametasona (predomínio do escore 1+), dextrano 70 a 32% (predomínio do escore 2+) e Ringer-lactato/hidrocortisona/dexametasona/ampicilina (predomínio do escore 2+). O período pós-operatório, representado pelo momento M3, e a técnica cirúrgica, predominantemente com escore 0, influíram na adesiólise e manutenção de aderências pélvicas em ratas. CONCLUSÕES: a prevenção de aderências pélvicas em ratas inicia-se no processo cirúrgico de baixo dano tecidual; o uso de substâncias profiláticas (soluções) tem eficácia variada, sendo que algumas mostraram-se mais eficazes que outras.

Effect of remifentanil hydrochloride administered via constant rate infusion on the minimum alveolar concentration of isoflurane in cats

Objective - To evaluate the effects of increasing doses of remifentanil hydrochloride administered via constant rate infusion (CRI) on the minimum alveolar concentration (MAC) of isoflurane in cats. Animals - 6 healthy adult cats. Procedures - For each cat, 2 experiments were performed (2-week interval). On each study day, anesthesia was induced and maintained with isoflurane; a catheter was placed in a cephalic vein for the administration of lactated Ringer's solution or remifentanil CRIs, and a catheter was placed in the jugular vein for collection of blood samples for blood gas analyses. On the first study day, individual basal MAC (MAC Basal) was determined for each cat. On the second study day, 3 remifentanil CRIs (0.25, 0.5, and 1.0 μg/kg/min) were administered (in ascending order); for each infusion, at least 30 minutes elapsed before determination of MAC (designated as MAC R0.25, MAC R0.5, and MAC R1.0, respectively). A 15-minute washout period was allowed between CRIs. A control MAC (MAC Control) was determined after the last remifentanil infusion. Results - Mean ± SD MAC Basal and MAC Control values at sea level did not differ significantly (1.66 ± 0.08% and 1.52 ± 0.21%, respectively). The MAC values determined for each remifentanil CRI did not differ significantly. However, MAC R0.25, MAC R0.5, and MAC R1.0, were significantly decreased, compared with MAC Basal, by 23.4 ± 79%, 29.8 ± 8.3%, and 26.0 ± 9.4%, respectively. Conclusions and Clinical Relevance - The 3 doses of remifentanil administered via CRI resulted in a similar degree of isoflurane MAC reduction in adult cats, indicating that a ceiling effect was achieved following administration of the lowest dose.

NGAL como marcador precoce de lesão renal em ratos submetidos à isquemia renal sob anestesia geral balanceada

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Meperidine and skin surface warming additively reduce the shivering threshold: a volunteer study

INTRODUCTION: Mild therapeutic hypothermia has been shown to improve outcome for patients after cardiac arrest and may be beneficial for ischaemic stroke and myocardial ischaemia patients. However, in the awake patient, even a small decrease of core temperature provokes vigorous autonomic reactions-vasoconstriction and shivering-which both inhibit efficient core cooling. Meperidine and skin warming each linearly lower vasoconstriction and shivering thresholds. We tested whether a combination of skin warming and a medium dose of meperidine additively would reduce the shivering threshold to below 34 degrees C without producing significant sedation or respiratory depression. METHODS: Eight healthy volunteers participated on four study days: (1) control, (2) skin warming (with forced air and warming mattress), (3) meperidine (target plasma level: 0.9 mug/ml), and (4) skin warming plus meperidine (target plasma level: 0.9 mug/ml). Volunteers were cooled with 4 degrees C cold Ringer lactate infused over a central venous catheter (rate asymptotically equal to 2.4 degrees C/hour core temperature drop). Shivering threshold was identified by an increase of oxygen consumption (+20% of baseline). Sedation was assessed with the Observer's Assessment of Alertness/Sedation scale. RESULTS: Control shivering threshold was 35.5 degrees C +/- 0.2 degrees C. Skin warming reduced the shivering threshold to 34.9 degrees C +/- 0.5 degrees C (p = 0.01). Meperidine reduced the shivering threshold to 34.2 degrees C +/- 0.3 degrees C (p < 0.01). The combination of meperidine and skin warming reduced the shivering threshold to 33.8 degrees C +/- 0.2 degrees C (p < 0.01). There were no synergistic or antagonistic effects of meperidine and skin warming (p = 0.59). Only very mild sedation occurred on meperidine days. CONCLUSION: A combination of meperidine and skin surface warming reduced the shivering threshold to 33.8 degrees C +/- 0.2 degrees C via an additive interaction and produced only very mild sedation and no respiratory toxicity.

Crystalloids versus colloids for goal-directed fluid therapy in major surgery

INTRODUCTION: Perioperative hypovolemia arises frequently and contributes to intestinal hypoperfusion and subsequent postoperative complications. Goal-directed fluid therapy might reduce these complications. The aim of this study was to compare the effects of goal-directed administration of crystalloids and colloids on the distribution of systemic, hepatosplanchnic, and microcirculatory (small intestine) blood flow after major abdominal surgery in a clinically relevant pig model. METHODS: Twenty-seven pigs were anesthetized and mechanically ventilated and underwent open laparotomy. They were randomly assigned to one of three treatment groups: the restricted Ringer lactate (R-RL) group (n = 9) received 3 mL/kg per hour of RL, the goal-directed RL (GD-RL) group (n = 9) received 3 mL/kg per hour of RL and intermittent boluses of 250 mL of RL, and the goal-directed colloid (GD-C) group (n = 9) received 3 mL/kg per hour of RL and boluses of 250 mL of 6% hydroxyethyl starch (130/0.4). The latter two groups received a bolus infusion when mixed venous oxygen saturation was below 60% ('lockout' time of 30 minutes). Regional blood flow was measured in the superior mesenteric artery and the celiac trunk. In the small bowel, microcirculatory blood flow was measured using laser Doppler flowmetry. Intestinal tissue oxygen tension was measured with intramural Clark-type electrodes. RESULTS: After 4 hours of treatment, arterial blood pressure, cardiac output, mesenteric artery flow, and mixed oxygen saturation were significantly higher in the GD-C and GD-RL groups than in the R-RL group. Microcirculatory flow in the intestinal mucosa increased by 50% in the GD-C group but remained unchanged in the other two groups. Likewise, tissue oxygen tension in the intestine increased by 30% in the GD-C group but remained unchanged in the GD-RL group and decreased by 18% in the R-RL group. Mesenteric venous glucose concentrations were higher and lactate levels were lower in the GD-C group compared with the two crystalloid groups. CONCLUSIONS: Goal-directed colloid administration markedly increased microcirculatory blood flow in the small intestine and intestinal tissue oxygen tension after abdominal surgery. In contrast, goal-directed crystalloid and restricted crystalloid administrations had no such effects. Additionally, mesenteric venous glucose and lactate concentrations suggest that intestinal cellular substrate levels were higher in the colloid-treated than in the crystalloid-treated animals. These results support the notion that perioperative goal-directed therapy with colloids might be beneficial during major abdominal surgery.

Goal-directed colloid administration improves the microcirculation of healthy and perianastomotic colon

BACKGROUND: The aim of this study was to compare the effects of goal-directed colloid fluid therapy with goal-directed crystalloid and restricted crystalloid fluid therapy on healthy and perianastomotic colon tissue in a pig model of colon anastomosis surgery. METHODS: Pigs (n = 27, 9 per group) were anesthetized and mechanically ventilated. A hand-sewn colon anastomosis was performed. The animals were subsequently randomized to one of the following treatments: R-RL group, 3 ml x kg(-1) x h(-1) Ringer lactate (RL); GD-RL group, 3 ml x kg(-1) x h(-1) RL + bolus 250 ml of RL; GD-C group, 3 ml x kg(-1) x h(-1) RL + bolus 250 ml of hydroxyethyl starch (HES 6%, 130/0.4). A fluid bolus was administered when mixed venous oxygen saturation dropped below 60%. Intestinal tissue oxygen tension and microcirculatory blood flow were measured continuously. RESULTS: After 4 h of treatment, tissue oxygen tension in healthy colon increased to 150 +/- 31% in group GD-C versus 123 +/- 40% in group GD-RL versus 94 +/- 23% in group R-RL (percent of postoperative baseline values, mean +/- SD; P < 0.01). Similarly perianastomotic tissue oxygen tension increased to 245 +/- 93% in the GD-C group versus 147 +/- 58% in the GD-RL group and 116 +/- 22% in the R-RL group (P < 0.01). Microcirculatory flow was higher in group GD-C in healthy colon. CONCLUSIONS: Goal-directed colloid fluid therapy significantly increased microcirculatory blood flow and tissue oxygen tension in healthy and injured colon compared to goal-directed or restricted crystalloid fluid therapy.

Avaliação da perfusão esplénica em modelo de hemorragia de suíno, após reperfusão com duas soluções fisiológicas distintas

O baço tem importantes funções hematopoiéticas e imunológicas, desempenhando um papel crucial na reposição da hipovolemia e de volume sanguíneo, em situações de hemorragia aguda. A administração de soluções fisiológicas tem grande importância na correção do volume circulante, evitando as complicações de hipovolemia. Este trabalho tem como objetivo avaliar as alterações provocadas no baço, após grave hemorragia dos suínos e reperfusão, utilizando duas soluções fisiológicas distintas, um cristaloide - solução de ringer lactato e um coloide - solução de hidroxietilamido. As lesões histopatológicas encontradas no baço foram congestão, hiperplasia da polpa branca, a notoriedade dos elipsoides e o infiltrado inflamatório, razão pela qual, se procedeu à sua avaliação semi-quantitativa. Relativamente à hiperplasia da polpa branca, foram encontradas diferenças estatisticamente significativas entre o grupo Ringer Lactato e o grupo Hidroxietilamido, verificando-se o aumento da hiperplasia da polpa branca no grupo Ringer Lactato. Quanto à área dos elipsoides, apenas um suíno em cada grupo registava grau 1. Houve uma preponderância do grau 2 no grupo de controlo (n = 5) e no grupo Ringer Lactato (n = 11), enquanto que no grupo Hidroxietilamido se registaram valores idênticos para os graus 2 e 3 (n = 5). A congestão ocorreu em todos os grupos, com predomínio do grau 2 (n = 7) nos grupos Ringer Lactato e Hidroxietilmido. Relativamente ao infiltrado inflamatório, no grupo de controlo predominou o grau 1 (n = 5) e registou-se a prevalência do grau 2 no grupo Ringer Lactato (n = 8) e no grupo Hidroxietilamido (n = 9). A área dos elipsoides variou nos diferentes grupos, não tendo revelado diferenças significativas entre os grupos. Foi observada congestão nos três grupos do estudo, não tendo sido, contudo, registadas diferenças significativas entre os grupos. Quanto ao infiltrado inflamatório, verificou-se que no grupo de controlo predominou o grau 1, enquanto que nos grupos Ringer Lactato e Hidroxietilamido prevaleceu o grau 2, o que se justifica pelo facto dos grupos Ringer Lactato e Hidroxietilamido terem sido submetidos a uma hemorragia. Foi assim possível concluir que a reperfusão volémica com Hidroxietilamido 130/0.4 pode reduzir a hiperreatividade esplénica, quando comparado com o Ringer Lactato, após hemorragia aguda. Verificamos que os elipsoides não sofrem qualquer afetação em situações de alterações hemodinâmicos. Atualizamos um sistema de classificação para avaliação de congestão esplénica, usando o modelo suíno. Aferimos que as situações causadoras de alterações hemodinâmicas ou da perfusão tecidual provocam aumento do infiltrado inflamatório.