Methylene blue improves hemodynamic shock but increases lipoperoxidation in severe acute pancreatitis pig model.
OBJECTIVE
Study hemodynamic pattern and lipoperoxidation during methylene blue (MB) treatment on taurocholate - enterokinase induced acute pancreatitis (AP).


METHODS
Thirty pigs were equally divided in control group; MB group; AP group; MB previous AP group; and MB after 90 min of induced AP group. MB was given iv in a bolus dose (2 mg.kg-1) followed by maintenance dose (2 mg.kg-1.h-1). Hemodynamic parameters were recorded continuously during 180 min by Swan-Ganz catheter. Blood samples were taken every 60 min to determine arterial and venous nitrate, malondialdehyde (MDA) and amylase. Pancreatic tissue was removed for histopathologic study.


RESULTS
In AP group MBP and CO decreased over time 33% (p<0.05) and 52% (p<0.05), respectively. In MB previous induced-AP group, there was 70 minutes delay (p<0.05) to decrease MBP and CO. In MB group arterial and venous nitrite decreased (p<0.05) over time. MB infusion increased (p>0.05) serum MDA when associated to AP. After induced AP, MB did not reverse MBP and CO decrease. There was no difference in serum amylase and necro-hemorrhagic findings with MB treatment.


CONCLUSIONS
In this taurocholate-induced AP model MB treatment delayed hemodynamic shock and decreases serum nitrate levels but increases serum MDA levels. No volemic replacement was done and it may have been a mitigated factor to a poor tissue perfusion and impairment microcirculation. Further investigations are needed to elucidate MB treatment role during AP treatment.
Department of Surgery and Anatomy, Ribeirão Preto Faculty of Medicine, University of São Paulo, SP, Brazil. roberto.meirelles@hcnet.usp.br
Roberto Ferreira
RF
Meirelles
Reginaldo
R
Ceneviva
Fernanda
F
Viaro
Caroline Floreoto
CF
Baldo
Paulo Roberto Barbosa
PR
Evora
D000208:Acute Disease; D000818:Animals; D015415:Biomarkers / Q000097:blood; D002756:Cholagogues and Choleretics; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical; D004765:Enteropeptidase; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects*; D015227:Lipid Peroxidation / Q000187:drug effects*; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008751:Methylene Blue / Q000627:therapeutic use*; D009566:Nitrates / Q000097:blood; D010195:Pancreatitis / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D012770:Shock, Cardiogenic / Q000188:drug therapy* / Q000503:physiopathology; D013552:Swine; D013656:Taurocholic Acid; D013997:Time Factors
D015415:Biomarkers; D002756:Cholagogues and Choleretics; D004791:Enzyme Inhibitors; D009566:Nitrates; D008315:Malondialdehyde; D013656:Taurocholic Acid; D004765:Enteropeptidase; D008751:Methylene Blue