Methylene blue improves hemodynamic shock but increases lipoperoxidation in severe acute pancreatitis pig model

Acta Cirurgica Brasileira

Roberto Ferreira Meirelles Jr²  Reginaldo Ceneviva²  Fernanda Viaro²  Caroline Floreoto Baldo²  Paulo Roberto Barbosa Evora¹ 

[1] ,University of São Paulo Ribeirão Preto Faculty of Medicine Department of Surgery and Anatomy SP ,Brazil

关键词: Acute Pancreatitis;    Methylene Blue;    Nitric Oxide;    Shock;    Lipoperoxidation;    Taurocholate;    Pancreatite Aguda;    Azul de Metileno;    Óxido Nítrico;    Choque Circulatório;    Lipoperoxidação;    Taurocolato;   

DOI  :  10.1590/S0102-86502008000700003

来源: SciELO

【 摘 要 】

PURPOSE: 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 (2mg.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.

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