title: Hemodynamic effects following intraperitoneal infusion of pancreatic ascites fluid.
abstract: Severe necrotizing pancreatitis is accompanied by release of hemorrhagic 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 +/- 1 kg) 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 6 h. 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 6 h 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.
authors.affiliation: Institute of Surgical Research, Ludwig-Maximilians-Universität, München, Federal Republic of Germany.
authors.forename: B
authors.initials: B
authors.lastname: Vollmar
authors.forename: H
authors.initials: H
authors.lastname: Waldner
authors.forename: M
authors.initials: M
authors.lastname: Vierl
authors.forename: T
authors.initials: T
authors.lastname: Kerner
authors.forename: P
authors.initials: P
authors.lastname: Lehnert
authors.forename: L
authors.initials: L
authors.lastname: Schweiberer
mesh_terms: D000208:Acute Disease; D000818:Animals; D001202:Ascitic Fluid / Q000503:physiopathology*; D004195:Disease Models, Animal; D015633:Extravascular Lung Water; D006439:Hemodynamics; D007022:Hypotension / Q000503:physiopathology*; D007213:Indomethacin / Q000008:administration & dosage; D007263:Infusions, Parenteral; D009200:Myocardial Contraction; D010195:Pancreatitis / Q000503:physiopathology; D010953:Plasma Volume; D011659:Pulmonary Gas Exchange; D013552:Swine
chemical_list: D007213:Indomethacin