[Interventional therapy of nonocclusive mesenteric ischemia with captopril: an experimental animal study].
OBJECTIVE
To clarify whether in nonocclusive mesenterial disease the extent of damage to the intestinal wall can be limited by local intraarterial application of Captopril.


METHODS
Producing shock by means of pericardial tamponade in 18 piglets. Examination of three groups: Intraarterial application of Captopril at the beginning of the shock phase (n = 6) or administration one hour after the beginning of the shock phase (n = 6), as well as a control group (n = 6). Analysis of clinical pathology (laboratory chemistry) and haemodynamic parameters over a test period of 4 hours and histological preparation of resected segments of the small intestine.


RESULTS
The initiation of therapy at the beginning of the shock improved the blood supply of the intestinal wall (measured by means of laser sonography in relative flow units RFU) from 226 RFU to 303 RFU; the rise in lactate from 2.7 to 3.6 mmol/l was significantly less (p = 0.05) than for the control group (from 3.1 to 11.5 mmol/l). The frequency and severity of the histological changes that are typical for ischaemia were less pronounced. If therapy was started only after a one-hour shock phase, this effect was no longer noticeable (rise in lactate from 5 to 9.5 mmol/l, intestinal wall blood flow from 168 to 170 RFU).


CONCLUSIONS
Intraarterial administration of Captopril can reduce the extent of damage in nonocclusive mesenterial ischaemia (nonocclusive disease) if therapy is initiated early enough.
Jakschik
J
J
Klinik und Poliklinik für Chirurgie, Bonn.
Jaeger
U
U
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D000818:Animals; D002216:Captopril / Q000008:administration & dosage*; D007261:Infusions, Intra-Arterial; D007511:Ischemia / Q000188:drug therapy*; D017538:Mesenteric Artery, Superior; D008643:Mesentery / Q000098:blood supply*; D015642:Radiology, Interventional; D012769:Shock / Q000188:drug therapy / Q000209:etiology; D013552:Swine; D013997:Time Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril
Interventionelle Therapie der nonokklusiven mesenterialen Ischämie mit Captopril--Eine tierexperimentelle Untersuchung.