title: Hyperbaric oxygen therapy reduces severity and improves survival in severe acute pancreatitis.
abstract: Severe acute pancreatitis is characterized by pancreatic necrosis, resulting in local and systemic inflammation. Hyperbaric oxygen (HBO) therapy modulates inflammation, but has not been extensively studied in pancreatitis. This study investigates the effects of HBO in a rat model of severe acute pancreatitis. Sixty-four rats were induced with severe pancreatitis using 4% sodium taurocholate and randomized to HBO treatment or control. HBO was commenced 6 h after induction (100% oxygen at 2.5 atmospheres for 90 min) and continued every 12 h for a maximum of eight treatment episodes. Surviving animals were killed at 7 days. Severity of pancreatitis was graded macroscopically and microscopically. Lung edema was calculated using wet and dry lung weights. Macroscopic and microscopic severity scores (mean +/- SE) of HBO-treated animals with pancreatitis (8.3 +/- 0.7; 9.6 +/- 0.4) were lower than those of controls (10.5 +/- 0.5; 11.1 +/- 0.4) (p = 0.02 and p = 0.03, respectively). The HBO-treated group had reduced pancreatic necrosis compared to controls (40 +/- 4% vs. 54 +/- 4%; p = 0.003). There was no difference in pulmonary edema between the groups. Median survival in the HBO-treatment group was 51 h, compared to 26 h in controls. Day-7 survival was significantly improved in the HBO-treated animals compared to controls (40% vs. 27%; p = 0.04). HBO therapy reduces overall severity, decreases the extent of necrosis, and improves survival in severe acute pancreatitis.
authors.affiliation: Department of Surgery, University of Melbourne, Austin Hospital, Lance Townsend Building Level 8, Studley Rd, Heidelberg, Melbourne, Victoria, 3084, Australia. surgery-armc@unimelb.edu.au
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Nikfarjam
authors.forename: Christine M
authors.initials: CM
authors.lastname: Cuthbertson
authors.forename: Caterina
authors.initials: C
authors.lastname: Malcontenti-Wilson
authors.forename: Vijayaragavan
authors.initials: V
authors.lastname: Muralidharan
authors.forename: Ian
authors.initials: I
authors.lastname: Millar
authors.forename: Christopher
authors.initials: C
authors.lastname: Christophi
mesh_terms: D000208:Acute Disease; D000818:Animals; D006931:Hyperbaric Oxygenation; D008297:Male; D010195:Pancreatitis / Q000401:mortality* / Q000628:therapy*; D051381:Rats; D017208:Rats, Wistar; D012720:Severity of Illness Index; D015996:Survival Rate