| Isovolemic hemodilution with dextran prevents contrast medium induced impairment of pancreatic microcirculation in necrotizing pancreatitis of the rat. | |
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MedLine Citation:
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PMID: 7529462 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Previous studies demonstrated that intravenous contrast medium (CM), as used in contrast enhanced computed tomography, aggravates the impairment of pancreatic microcirculation (PM) characteristic of severe pancreatitis and increases necrosis and mortality in necrotizing pancreatitis (NP) in rats. This study evaluates the use of isovolemic hemodilution, which can enhance the microcirculation in severe pancreatitis, for preventing CM-induced injury. METHODS: NP was induced in 30 dextran-tolerant Wistar rats by intraductal glycodeoxycholic acid and intravenous cerulein for 6 hours. PM was quantified by intravital microscopy using fluorescein isothiocyanate labeled erythrocytes. Based on previous results, areas with low blood flow (< 1.6 nL/min/cap) were identified and baseline recordings of capillary blood flow taken. A reduction of hematocrit to 75% of baseline was achieved by replacement of 5 mL/kg of blood with 25 mL/kg Ringer's lactate (RL) or by exchange of 8 mL/kg of blood for the same amount of dextran 70.6%. Thereafter, the nonionic CM iopamidol (Solutrast, Byk Gulden, Konstanz, Germany) was injected during 1 minute and PM measurements repeated after 30 and 60 minutes. RESULTS: Despite hemodilution with RL, pancreatic capillary perfusion was significantly decreased to 87% of baseline (0.83 +/- 0.04 mL/min/cap; n = 216) 60 minutes after CM infusion (P < 0.05). In contrast, capillary blood flow was significantly increased to 161% (1.56 +/- 0.05 nL/min/cap; n = 278) in the group treated with dextran. Moreover, the percentage of capillaries developing complete stasis was significantly lower in the dextran group (2.3 +/- 1.2%) compared to animals diluted with RL (22.3 +/- 4.8%) (P < 0.002). CONCLUSION: Isovolemic hemodilution with dextran prevents the additional impairment of pancreatic microcirculation induced by CM in NP. |
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Authors:
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H G Hotz; J Schmidt; E W Ryschich; T Foitzik; H J Buhr; A L Warshaw; C Herfarth; E Klar |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American journal of surgery Volume: 169 ISSN: 0002-9610 ISO Abbreviation: Am. J. Surg. Publication Date: 1995 Jan |
Date Detail:
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Created Date: 1995-02-07 Completed Date: 1995-02-07 Revised Date: 2003-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0370473 Medline TA: Am J Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 161-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, University of Heidelberg, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Animals Contrast Media / adverse effects* Dextrans / therapeutic use* Hemodilution* Ischemia / chemically induced, prevention & control* Male Necrosis Pancreas / blood supply* Pancreatitis / pathology* Rats Rats, Wistar |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 9004-54-0/Dextrans |
| Comments/Corrections | |
Comment In:
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Am J Surg. 1997 May;173(5):458
[PMID:
9168095
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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