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Hemodynamic effects following intraperitoneal infusion of pancreatic ascites fluid

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Research in Experimental Medicine

Summary

Severe necrotizing pancreatitis is accompanied by release of hemorhagic ascites fluid (HAF), which is thought to be related to the occurrence and frequency of cardiocirculatory and pulmonary failure as a consequence of acute pancreatitis. The purpose of this study was to evaluate the role of HAF due to these systemic complications. Experiments were performed in 25 pigs (mean b.wt. 22±1kg) under general anesthesia and mechanical ventilation. The animals received 50 ml/kg b.wt. i.p. of either physiologic saline solution (control CO,n=9) or hemorrhagic ascites fluid (HAF,n=16). HAF was obtained from 16 pigs with pancreatitis induced by intraductal infusion of bile salt. Eight animals in the HAF group were pretreated with indomethacin (10 mg/kg i.v. INDO/HAF). All animals were followed up for 6h.

Mean arterial pressure, cardiac output, and stroke volume fell significantly in the HAF(−25%, −27%, −27%) and in the INDO/HAF groups (−24%, −20%, −17%) as compared with controls (−6%, −6%, −6%). Also, left ventricular end-diastolic pressure (LVEDP) decreased by 52% and 48% in both HAF recipient groups, whereas LVEDP was unchanged in the control group. Myocardial contractility (Vmax) remained unaltered in all experimental groups. No significant differences in gas exchange and lung dry/wet weight ratio were observed. Lipase and PGI2 of the unpretreated HAF group rised to 203% and 198% in arterial blood at 6h compared with unaltered levels in the control group. No increase of prostanoid concentrations was detected in the indomethacin-pretreated group, whereas lipase increase by a comparable extent as in the HAF group. We conclude that the early consequences of HAF are mainly characterized by systemic hypotension due to hypovolemia.

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Authors and Affiliations

  1. Institute of Surgical Research and the Department of Surgery, Klinikum Innenstadt, Ludwig-Maximilians-Universität, Marchioninistrasse 15, W-8000, München 70, Federal Republic of Germany

    B. Vollmar, H. Waldner, M. Vierl, T. Kerner, P. Lehnert & L. Schweiberer

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  1. B. Vollmar
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  2. H. Waldner
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  3. M. Vierl
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  4. T. Kerner
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  5. P. Lehnert
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  6. L. Schweiberer
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Vollmar, B., Waldner, H., Vierl, M. et al. Hemodynamic effects following intraperitoneal infusion of pancreatic ascites fluid. Res. Exp. Med. 192, 269–279 (1992). https://doi.org/10.1007/BF02576283

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  • DOI: https://doi.org/10.1007/BF02576283

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