Effects of hydroxyethyl starch and cell-free hemoglobin on microcirculation, tissue oxygenation, and survival in severe acute porcine pancreatitis
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Effects of hydroxyethyl starch and cell-free hemoglobin on microcirculation, tissue oxygenation, and survival in severe acute porcine pancreatitis : results of a randomized experimental trial. / Bachmann, Kai; Freitag, Marc; Lohalm, Hendrik; Tomkötter, Lena; Dupree, Anna; Koops, Susan; Strate, Tim; Izbicki, Jakob R; Mann, Oliver.
in: PANCREAS, Jahrgang 43, Nr. 6, 08.2014, S. 855-62.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Effects of hydroxyethyl starch and cell-free hemoglobin on microcirculation, tissue oxygenation, and survival in severe acute porcine pancreatitis
T2 - results of a randomized experimental trial
AU - Bachmann, Kai
AU - Freitag, Marc
AU - Lohalm, Hendrik
AU - Tomkötter, Lena
AU - Dupree, Anna
AU - Koops, Susan
AU - Strate, Tim
AU - Izbicki, Jakob R
AU - Mann, Oliver
PY - 2014/8
Y1 - 2014/8
N2 - OBJECTIVE: Severe acute pancreatitis is a life-threatening disease with a high mortality; so far, no causal treatment is known. The aim of this study was to evaluate the therapeutic potential of hydroxyethyl starch (HES) and cell-free hemoglobin in an experimental model.METHODS: Thirty-nine pigs were randomly assigned into 3 groups. Severe acute pancreatitis was induced by intraductal injection of glycodeoxycholic acid in combination with intravenous administration of cerulein. All animals were kept in isovolemic conditions by application of Ringer solution, 10% HES, or cell-free hemoglobin. The pancreatic microcirculation was evaluated over 8 hours. Thereafter, the animals were observed for 6 days followed by killing of the animals and histopathologic examination.RESULTS: The administration of HES and cell-free hemoglobin led to improved microcirculation and tissue oxygenation compared with the Ringer's group. Consequently, the histopathologic damage was reduced (5.5 [3-8.5] vs 9.5 [7.5-11]; P < 0.001). In addition, the mean survival was significantly longer at 121 hours (95% confidence interval, 102-139) versus the Ringer group's 57 hours (95% confidence interval, 32-82; P < 0.001).CONCLUSIONS: The administration of HES and cell-free hemoglobin can improve microcirculation in severe acute porcine pancreatitis, with consequent reduction in histopathologic damage and mortality. Therefore, this might represent an interesting therapeutic option in the treatment of severe acute pancreatitis.
AB - OBJECTIVE: Severe acute pancreatitis is a life-threatening disease with a high mortality; so far, no causal treatment is known. The aim of this study was to evaluate the therapeutic potential of hydroxyethyl starch (HES) and cell-free hemoglobin in an experimental model.METHODS: Thirty-nine pigs were randomly assigned into 3 groups. Severe acute pancreatitis was induced by intraductal injection of glycodeoxycholic acid in combination with intravenous administration of cerulein. All animals were kept in isovolemic conditions by application of Ringer solution, 10% HES, or cell-free hemoglobin. The pancreatic microcirculation was evaluated over 8 hours. Thereafter, the animals were observed for 6 days followed by killing of the animals and histopathologic examination.RESULTS: The administration of HES and cell-free hemoglobin led to improved microcirculation and tissue oxygenation compared with the Ringer's group. Consequently, the histopathologic damage was reduced (5.5 [3-8.5] vs 9.5 [7.5-11]; P < 0.001). In addition, the mean survival was significantly longer at 121 hours (95% confidence interval, 102-139) versus the Ringer group's 57 hours (95% confidence interval, 32-82; P < 0.001).CONCLUSIONS: The administration of HES and cell-free hemoglobin can improve microcirculation in severe acute porcine pancreatitis, with consequent reduction in histopathologic damage and mortality. Therefore, this might represent an interesting therapeutic option in the treatment of severe acute pancreatitis.
KW - Acute Disease
KW - Animals
KW - Ceruletide
KW - Glycodeoxycholic Acid
KW - Hemoglobins/administration & dosage
KW - Hydroxyethyl Starch Derivatives/administration & dosage
KW - Isotonic Solutions/administration & dosage
KW - Microcirculation/drug effects
KW - Oxygen Consumption/drug effects
KW - Pancreas/drug effects
KW - Pancreatitis/chemically induced
KW - Random Allocation
KW - Ringer's Solution
KW - Severity of Illness Index
KW - Survival Analysis
KW - Swine
KW - Treatment Outcome
U2 - 10.1097/MPA.0000000000000146
DO - 10.1097/MPA.0000000000000146
M3 - SCORING: Journal article
C2 - 24809409
VL - 43
SP - 855
EP - 862
JO - PANCREAS
JF - PANCREAS
SN - 0885-3177
IS - 6
ER -