Intravenous Contrast Medium Aggravates the Impairment of Pancreatic Microcirculation in Necrotizing Pancreatitis in the Rat

Overview

Journal Ann Surg

Specialty General Surgery

Date 1995 Mar 1

PMID 7717779

Citations 18

Authors

J Schmidt

H G Hotz

T Foitzik

E Ryschich

H J Buhr

A L Warshaw

C Herfarth

E Klar

Affiliations

Soon will be listed here.

Abstract

Background: Previous reports demonstrated that radiographic contrast medium, as used in contrast-enhanced computed tomography, increases acinar necrosis and mortality in experimental pancreatitis. The authors studied the possibility that these changes may be related to an additional impairment of pancreatic microcirculation.

Methods: Fifty Wistar rats had acute pancreatitis induced by intraductal glycodeoxycholic acid (10 mmol/L for 10 min) and intravenous cerulein (5 micrograms/kg/hr for 6 hrs). After rehydration (16 mL/kg), pancreatic capillary perfusion was quantified by means of intravital microscopy at baseline before intravenous infusion of contrast medium (n = 25) or saline (n = 25), and 30 and 60 minutes thereafter. In addition to total capillary flow, capillaries were categorized as high- or low-flow (> or < 1.6 nL/min).

Results: Pancreatic capillary flow did not change in either high- or low-flow capillaries after saline infusion. However, contrast medium infusion induced a significant decrease of total capillary flow (p < 0.001). Analysis according to the relative flow rate revealed that this was primarily because of a significant additional reduction of perfusion in low-flow capillaries (p < 0.0001). Furthermore, complete capillary stasis was observed in 15.9 +/- 3.4% after contrast medium as compared with 3.2 +/- 1.2% after saline infusion (p < 0.006).

Conclusion: Radiographic contrast medium aggravates the impairment of pancreatic microcirculation in experimental necrotizing pancreatitis.

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References

Schmidt J, Fernandez-Del Castillo C, Rattner D, Lewandrowski K, Compton C, Warshaw A . Trypsinogen-activation peptides in experimental rat pancreatitis: prognostic implications and histopathologic correlates. Gastroenterology. 1992; 103(3):1009-16. DOI: 10.1016/0016-5085(92)90036-x. View

Foitzik T, Bassi D, Fernandez-Del Castillo C, Warshaw A, Rattner D . Intravenous contrast medium impairs oxygenation of the pancreas in acute necrotizing pancreatitis in the rat. Arch Surg. 1994; 129(7):706-11. DOI: 10.1001/archsurg.1994.01420310038006. View

Klar E, Mall G, Messmer K, Herfarth C, Rattner D, Warshaw A . Improvement of impaired pancreatic microcirculation by isovolemic hemodilution protects pancreatic morphology in acute biliary pancreatitis. Surg Gynecol Obstet. 1993; 176(2):144-50. View

Hurley P, Cook A, Jehanli A, Austen B, Hermon-Taylor J . Development of radioimmunoassays for free tetra-L-aspartyl-L-lysine trypsinogen activation peptides (TAP). J Immunol Methods. 1988; 111(2):195-203. DOI: 10.1016/0022-1759(88)90127-5. View

Akagi M, Masaki S, Kitazumi K, Mio M, Tasaka K . Comparative study of the adverse effects of various radiographic contrast media, including ioversol, a new low-osmolarity medium. II. The complement system and endothelial cells. Methods Find Exp Clin Pharmacol. 1991; 13(7):449-54. View

Larvin M, Chalmers A, McMahon M . Dynamic contrast enhanced computed tomography: a precise technique for identifying and localising pancreatic necrosis. BMJ. 1990; 300(6737):1425-8. PMC: 1663140. DOI: 10.1136/bmj.300.6737.1425. View

Schmidt J, Lewandrowsi K, Warshaw A, Compton C, Rattner D . Morphometric characteristics and homogeneity of a new model of acute pancreatitis in the rat. Int J Pancreatol. 1992; 12(1):41-51. DOI: 10.1007/BF02927069. View

Balthazar E, Ranson J, Naidich D, Megibow A, Caccavale R, Cooper M . Acute pancreatitis: prognostic value of CT. Radiology. 1985; 156(3):767-72. DOI: 10.1148/radiology.156.3.4023241. View

Buchler M, Malfertheiner P, Schoetensack C, Uhl W, Beger H . Sensitivity of antiproteases, complement factors and C-reactive protein in detecting pancreatic necrosis. Results of a prospective clinical study. Int J Pancreatol. 1986; 1(3-4):227-35. DOI: 10.1007/BF02795248. View

10.

Aspelin P . Effect of ionic and non-ionic contrast media on whole blood viscosity, plasma viscosity and hematocrit in vitro. Acta Radiol Diagn (Stockh). 1978; 19(6):977-89. DOI: 10.1177/028418517801900613. View

11.

Gudgeon A, Heath D, Hurley P, Jehanli A, Patel G, Wilson C . Trypsinogen activation peptides assay in the early prediction of severity of acute pancreatitis. Lancet. 1990; 335(8680):4-8. DOI: 10.1016/0140-6736(90)90135-r. View

12.

Clavien P, Hauser H, Meyer P, Rohner A . Value of contrast-enhanced computerized tomography in the early diagnosis and prognosis of acute pancreatitis. A prospective study of 202 patients. Am J Surg. 1988; 155(3):457-66. DOI: 10.1016/s0002-9610(88)80113-2. View

13.

Fernandez-Del Castillo C, Schmidt J, Rattner D, Lewandrowski K, Compton C, Jehanli A . Generation and possible significance of trypsinogen activation peptides in experimental acute pancreatitis in the rat. Pancreas. 1992; 7(3):263-70. DOI: 10.1097/00006676-199205000-00001. View

14.

Eaton S, Tsay H, Yost F, Tweedle M . Assays for plasma complement activation by x-ray contrast media. Invest Radiol. 1990; 25(7):789-92. DOI: 10.1097/00004424-199007000-00007. View

15.

Desjardins C, Duling B . Microvessel hematocrit: measurement and implications for capillary oxygen transport. Am J Physiol. 1987; 252(3 Pt 2):H494-503. DOI: 10.1152/ajpheart.1987.252.3.H494. View

16.

Rosenthal A, Litwin S, LAVER M . Effect of contrast media used in angiocardiography on hemoglobin-oxygen equilibrium. Invest Radiol. 1973; 8(4):191-8. DOI: 10.1097/00004424-197307000-00002. View

17.

Vetterlein F, Petho A, Schmidt G . Morphometric investigation of the microvascular system of pancreatic exocrine and endocrine tissue in the rat. Microvasc Res. 1987; 34(2):231-8. DOI: 10.1016/0026-2862(87)90056-2. View

18.

Nuutinen P, Kivisaari L, Lempinen M, Schroder T . Microangiography of the pancreas in experimental oedemic and haemorrhagic pancreatitis. Scand J Gastroenterol Suppl. 1986; 126:12-7. DOI: 10.3109/00365528609091885. View

19.

Butcher E, Weissman I . Direct fluorescent labeling of cells with fluorescein or rhodamine isothiocyanate. I. Technical aspects. J Immunol Methods. 1980; 37(2):97-108. DOI: 10.1016/0022-1759(80)90195-7. View

20.

PFEFFER R, LAZZARINI-ROBERTSON Jr A, SAFADI D, Mixter Jr G, SECOY C, HINTON J . Gradations of pancreatitis, edematous, through hemorrhagic, experimentally produced by controlled injection of microspheres into blood vessels in dogs. Surgery. 1962; 51:764-9. View