Document Detail


Splanchnic tissue perfusion in acute experimental pancreatitis.
MedLine Citation:
PMID:  10232878     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Gut hypoperfusion may have a role in the pathogenesis of multiple organ failure, which is a the main cause of death in severe acute pancreatitis. We hypothesized that gut hypoperfusion is present early in acute pancreatitis and that supporting the systemic hemodynamics by fluid resuscitation would prevent this. METHODS: In a pig model of randomized, controlled experimental hemorrhagic pancreatitis induced by Na-taurocholate the animals were divided into four groups (n = 6 for each): 1) pancreatitis, 2) control, 3) pancreatitis and fluid resuscitation to keep the pulmonary capillary wedge pressure at 5 to 6 mmHg, and 4) control and fluid resuscitation as in group 3. Splanchnic perfusion was assessed by means of local PCO2 gap with intestinal tonometer, oxygen delivery and consumption, lactate production, and blood flow. The follow-up time was 6 h. RESULTS: The Pco2 gap increased in pancreatitis (1.72+/-0.17, 1.94+/-0.29, 1.75+/-0.22, 2.32+/-0.33; 9.40+/-2.16, 3.72+/-1.78, 0.84+/-0.39, 1.11+/-0.21 kPa, respectively; P < 0.05). Oxygen delivery in portal-drained organs decreased in pancreatitis (2.5+/-0.3, 2.6+/-0.2, 2.8+/-0.4, 2.3+/-0.2; 1.7+/-0.3, 2.3+/-0.3, 2.4+/-0.5, 2.3+/-0.3 ml/min x kg, respectively; P < 0.05). Regional oxygen consumption did not change. Arterial plasma lactate increased (1.20+/-0.19, 1.33+/-0.16, 1.14+/-0.15, 1.43+/-0.33; 3.81+/-1.31, 1.48+/-0.48, 1.12+/-0.18, 1.18+/-0.35 mmol/l, respectively; P < 0.05). The portal venous blood flow decreased 50% in pancreatitis, but with fluid resuscitation it increased 50%. CONCLUSIONS: Splanchnic hypoperfusion is present early in acute hemorrhagic pancreatitis. The signs of hypoperfusion can be prevented with fluid resuscitation.
Authors:
P O Juvonen; J J Tenhunen; A A Heino; M Merasto; H E Paajanen; E M Alhava; J A Takala
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  34     ISSN:  0036-5521     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-06-24     Completed Date:  1999-06-24     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  NORWAY    
Other Details:
Languages:  eng     Pagination:  308-14     Citation Subset:  IM    
Affiliation:
Dept. of Surgery, Kuopio University Hospital, Finland.
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MeSH Terms
Descriptor/Qualifier:
Animals
Fluid Therapy*
Gastrointestinal Hemorrhage / chemically induced,  physiopathology*
Intestines / blood supply*
Pancreatitis, Acute Necrotizing / chemically induced,  physiopathology*
Random Allocation
Splanchnic Circulation / physiology*
Swine
Taurocholic Acid
Chemical
Reg. No./Substance:
81-24-3/Taurocholic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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