We investigated whether the timing of administration of contrast medium after onset of acute pancreatitis is critical in determining the magnitude of microcirculatory derangement.
An acute pancreatitis model in male Sprague-Dawley rats (225–275 g) was established by continuous infusion of cerulein (15 mg/kg per hour). The mean arterial pressure was monitored continuously by means of a femoral artery catheter. Diatrizoate (Hypaque-76), a water-soluble contrast medium, was delivered through a femoral vein catheter at doses corresponding to those given to humans, either 1, 2, or 3 hours after pancreatitis induction. In vivo microscopy and laser-Doppler flowmetry were used to investigate microcirculatory derangement. The water contents of the pancreas and lung, the malondialdehyde levels of the pancreas, and the trypsinogen activation peptide levels in the serum were measured at the end of the experiment (8 hours after infusion of cerulein).
Early administration of contrast medium (1 hour after pancreatitis induction) resulted in significantly greater changes in microcirculation and mean arterial pressure than did late administration (2 or 3 hours after pancreatitis induction). Rats given contrast medium 1 hour after induction also had highest pancreas and lung water contents, the highest pancreas malondialdehyde levels, and the highest serum trypsinogen activation peptide levels.
These results show that a water soluble contrast medium that is often used for computed tomographic imaging of the pancreas can adversely affect the pancreatic microcirculatory parameters, such as tissue perfusion and leukocyte sticking, and hemodynamics in a cerulein-induced model of acute pancreatitis. Early administration seems to cause more severe derangement of the pancreatic microcirculation.
From the Department of Surgery (H.-M.C., C.-P.C., T.-Y.C., C.-C.L., M.-F.C.) and Anaesthesia (M.-H.S.), Chang Gung Memorial Hospital, Chang Gung University School of Medicine, Taipei, Taiwan, Republic of China.
Address for reprints: Han-Ming Chen, Department of Surgery, Chang Gung Memorial Hospital 199, Tun-Hwa North Road, Taipei, Taiwan; email: email@example.com.
Submitted for publication June 23, 1999.
Accepted for publication December 30, 1999.
This work is supported by research grant NSC 88–2314-B182A-070 from the National Science Council, Taiwan.