November 12, 2014
Notes: Bai, Lu
Research Support, Non-U.S. Gov’t
Sichuan Da Xue Xue Bao Yi Xue Ban. 2013 Nov;44(6):982-6.
Author Address: Department of Integrated Traditional Chinese Medcine and Western Medcine, West China Hospital, Sichuan University, Chengdu 610041, China.
Reference Type: Journal Article
Record Number: 4610Author: Baldo, C. F., Capellini, V. K., Celotto, A. C., Sonego, F., Tirapelli, L. F., Batalhao, M., Carnio, E. C., dos Santos, J. S. and Evora, P. R.
Title: Guanylate cyclase inhibition by methylene blue in circulatory shock caused by acute necrotizing pancreatitis: a word of caution based on a porcine model
Journal: Rev Col Bras Cir
Short Title: Guanylate cyclase inhibition by methylene blue in circulatory shock caused by acute necrotizing pancreatitis: a word of caution based on a porcine model
Alternate Journal: Revista do Colegio Brasileiro de Cirurgioes
ISSN: 1809-4546 (Electronic)
Accession Number: 24573627
Abstract: OBJECTIVE: To study the therapeutic application of guanylate cyclase inhibition by methylene blue in an experimental model of acute pancreatitis in pigs. METHODS: acute necrotizing pancreatitis was induced in anesthetized pigs by the retrograde infusion of 1 ml/kg of 5% sodium taurocholate and 8 U/kg enterokinase in the pancreatic duct. Three groups were studied (n = 5): control (C), pancreatitis (AP), and MB bolus followed by pancreatitis (MB+P). The data included serum and abdominal fluid enzymes, hemodynamic variables, arterial hemogasometry, abdominal fluid volume, inflammatory markers, plasma nitrite/nitrate (NOx), plasma myeloperoxidase (MPO) and plasma malondialdehyde (MDA). One- and two-way analysis of variance (ANOVA) was performed, followed by the Bonferroni test (p < 0.05). RESULTS: amylase and lipase were three and 10-fold higher in the AP group. Myeloperoxidase activity was 50% higher in the AP group. The hemodynamic data indicated early hypovolemic shock followed by cardiogenic shock. Severe fluid translocation to the peritoneal cavity was observed. Plasma NOx remained unchanged. The MB+P group had a five-fold increase in MDA compared with the C group. CONCLUSION: preemptive application of MB in pigs with AP demonstrated no significant effects on hemodynamic and inflammatory variables. The use of MB is inadequate in cases of exponential NO release, and extreme caution must be exercised, given the increase in lipid peroxidation based on the malondialdehyde dosage.