Document Detail

Benefits of various dextrans after delayed therapy in necrotizing pancreatitis of the rat.
MedLine Citation:
PMID:  9120115     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Ultrahigh-molecular dextran (500,000 Da) has been shown to prevent pancreatic necrosis when given 30 min after induction of pancreatitis. This study should clarify the following: (a) are dextrans still effective after prolongation of the therapy-free interval? (b) what is the impact of the molecular weight of the dextrans? and (c) is their effect influenced by the dextran concentration or by the addition of hypertonic saline? ANIMALS AND INTERVENTIONS: Acute pancreatitis was induced in 70 male dextran-tolerant Wistar rats using intraductal bile-salt infusion and intravenous hyperstimulation. After 3 h, animals were assigned to one of seven groups (n = 10 per group) receiving either Ringer solution or different dextrans (10%) including 70,000 Da (DEX-70), 160,000 Da (DEX-160), 300,000 Da (DEX-300) or 500,000 Da (DEX-500). Additional groups included DEX-70 (6%) and DEX-70 (10%) in combination with hypertonic NaCl (7.5%) (HHS-70). Ringer solution was given at 24 ml/kg and all dextrans at 8 ml/kg. MEASUREMENTS AND RESULTS: Trypsinogen activation peptides (TAP) were quantified in ascites and acinar necrosis after death or sacrifice at 9 h. As an index of less pathological trypsinogen activation, the mean TAP levels in ascites were significantly lower in DEX-70 and DEX-160 compared to Ringer controls (p < 0.05, t-test). Furthermore, the amount of acinar necrosis was significantly lower in all dextran groups except the HHS-70 in comparison with Ringer controls (p < 0.01, t-test). Finally, mortality was significantly reduced from 60% in Ringer controls to 10 and 0%, respectively, in the groups treated with DEX-70 and DEX-160 (p < 0.03, Fisher's Exact test). There was a similar trend in all other groups except the HHS-70. CONCLUSIONS: Despite a therapy-free interval of 3 h, dextrans reduce trypsinogen activation, prevent acinar necrosis, and improve survival in necrotizing rodent pancreatitis. The molecular weight and concentration of dextran are of secondary importance for these beneficial effects.
J Schmidt; K Huch; K Mithöfer; H G Hotz; H P Sinn; H J Buhr; A L Warshaw; C Herfarth; E Klar
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Intensive care medicine     Volume:  22     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  1996 Nov 
Date Detail:
Created Date:  1997-04-22     Completed Date:  1997-04-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1207-13     Citation Subset:  IM    
Department of Surgery, University of Heidelberg, Germany.
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MeSH Terms
Anticoagulants / therapeutic use*
Dextrans / therapeutic use*
Disease Models, Animal
Hypertonic Solutions
Microcirculation / drug effects
Pancreas / blood supply
Pancreatitis, Acute Necrotizing / drug therapy*,  pathology
Random Allocation
Rats, Wistar
Trypsinogen / metabolism
Reg. No./Substance:
0/Anticoagulants; 0/Colloids; 0/Hypertonic Solutions; 9002-08-8/Trypsinogen; 9004-54-0/Dextrans

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