Detrimental effects of octreotide on intestinal microcirculation.
BACKGROUND
Octreotide (OCT) is used for the protection of pancreato-intestinal anastomoses and for treatment of acute pancreatitis. Its effect on jejunal microcirculation after ischemia-reperfusion has not been investigated.


METHODS
Intestinal ischemia was induced in Wistar rats (n = 8) by occlusion of the superior mesenteric artery for 40 min. Prior to reperfusion infusion of OCT (7.5 microgram/h) was started (n = 8). Microvascular perfusion of the jejunal mucosal and muscle layers was assessed and compared with that of groups without intervention (n = 16) by means of intravital microscopy.


RESULTS
Ischemia-reperfusion decreased mucosal functional capillary density from 838.4 +/- 12.6 to 418.9 +/- 9.6 cm(-1). Mucosal capillary red blood cell velocity was reduced from 0.53 +/- 0.01 to 0.35 +/- 0.01 mm/s (P < 0.05). Permanent leukocyte adherence was increased. OCT without ischemia-reperfusion decreased functional capillary density (735.4 +/- 13.5 cm(-1)) and red blood cell velocity (0.46 +/- 0.01 mm/s). After reperfusion OCT led to perfusion heterogeneity demonstrated by villous stasis (26 +/- 4%) and a decrease in the index of mucosal perfusion (0.38 +/- 0.02). Functional capillary density was further decreased compared with ischemic controls (234.0 +/- 11.8 cm(-1)). Capillary red blood cell velocity was lower (0.30 +/- 0.01 mm/s) than in ischemic controls.


CONCLUSIONS
OCT impairs microvascular perfusion of the jejunum both under physiological conditions and after ischemia-reperfusion.
Heuser
M
M
Department of Surgery, Klinikum Mannheim, Mannheim, Germany. mheuser@gwdg.de
Pöpken
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Kleiman
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D000818:Animals; D001783:Blood Flow Velocity; D002196:Capillaries / Q000187:drug effects / Q000502:physiology / Q000503:physiopathology*; D002448:Cell Adhesion; D005260:Female; D007413:Intestinal Mucosa / Q000098:blood supply*; D007511:Ischemia / Q000503:physiopathology*; D007583:Jejunum / Q000098:blood supply*; D007962:Leukocytes / Q000502:physiology; D008833:Microcirculation / Q000187:drug effects* / Q000502:physiology / Q000503:physiopathology; D015282:Octreotide / Q000494:pharmacology*; D051381:Rats; D017208:Rats, Wistar; D015424:Reperfusion
D015282:Octreotide