Document Detail

Effects of positive end-expiratory pressure (PEEP) ventilation on the exocrine pancreas in minipigs.
MedLine Citation:
PMID:  1722048     Owner:  NLM     Status:  MEDLINE    
The effect of positive end-expiratory pressure (PEEP) ventilation on the pancreas was studied in 22 anesthetized minipigs. Five pigs were treated with intermittent positive pressure ventilation (IPPV) for 21 h (Group I) and six pigs were treated with a PEEP of 15 cm H2O for 21 h (Group II). We next explored the influence of PEEP ventilation while stimulating the pancreas with Ceruletide, a synthetic cholecystokinin (CCK) analog, at 2.3 micrograms/kg per h.i.v. for 3 h. Ventilation with IPPV for 4 h (n = 5, group III) was compared with PEEP of 15 cm H2O for 4 h (n = 6, group IV). Changes in serum-lipase were observed in all groups. The average lipase level rose from 12.6 U/l to 67 U/l group I and from 15.1 U/l to 129.2 U/l in group II (P = 0.025 for group I vs group II). In group IV (PEEP and Ceruletide), the mean lipase level rose about six times more than in group III (IPPV and Ceruletide). The difference was significant (P less than 0.00005). By three-factor ANOVA analysis, effects due to the drug (P less than 0.000006) and to PEEP (P less than 0.038) as well as a threefold interaction could be demonstrated, i.e., using Ceruletide a greater PEEP effect on lipase than without the drug (P less than 0.023) took place. There were no significant histological changes of the pancreas in groups I and III. In group II (21 h PEEP), vacuolization of acinar cells was evident; on the ultrastructural level, indication was given that these vacuoles derived both from the Golgi apparatus and from fusion of individual zymogen granules. In group IV (PEEP and Ceruletide), the focal appearance of fatty-tissue necrosis and acinar cells as well as hemorrhage of the gland was observed. We conclude that PEEP ventilation impairs the function of the pancreas and produces even more deleterious effects when the gland is stimulated. These effects should be considered when PEEP is used in clinical practice in the treatment of acute pancreatitis.
M Kahle; J Lippert; S Willemer; W Pabst; P Martin
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Research in experimental medicine. Zeitschrift für die gesamte experimentelle Medizin einschliesslich experimenteller Chirurgie     Volume:  191     ISSN:  0300-9130     ISO Abbreviation:  Res Exp Med (Berl)     Publication Date:  1991  
Date Detail:
Created Date:  1992-02-06     Completed Date:  1992-02-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0324736     Medline TA:  Res Exp Med (Berl)     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  309-25     Citation Subset:  IM    
Department of General and Thoracic Surgery, University Giessen, Federal Republic of Germany.
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MeSH Terms
Amylases / blood,  secretion*
Caerulein / pharmacology
Cardiac Output, Low / etiology,  physiopathology
Intermittent Positive-Pressure Ventilation
Lipase / blood,  secretion*
Lung / secretion
Pancreas / blood supply,  drug effects,  secretion*,  ultrastructure
Positive-Pressure Respiration / adverse effects*
Prostaglandins / secretion
Secretory Rate / drug effects
Swine, Miniature
Reg. No./Substance:
0/Prostaglandins; 17650-98-5/Caerulein; EC; EC 3.2.1.-/Amylases

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