Peritoneal lavage combined with volume therapy in porcine hemorrhagic pancreatitis. Effects on hemodynamics, microcirculation, and peritoneal morphology.

Abstract

Acute hemorrhagic pancreatitis was induced in 15 piglets, after which 8 of the piglets were treated with saline infusion only and 7 were treated with saline infusion and peritoneal lavage. Hemodynamic variables were measured hourly. Organ and peritoneal blood flow was determined at 0, 1, and 5 h with radioactive microspheres. Peritoneal morphology was studied at 0, 1, 3, and 5 h with light microscopy and scanning electron microscopy. According to the results, changes in cardiac output, mean blood pressure, and peritoneal blood flow and the peritoneal inflammatory reaction were similar in the two groups. However, a significant increase in heart rate and a significant decrease in the blood flow to the pancreas, liver, and spleen were observed in the saline group, in contrast to the lavage group. In addition, blood flow to the adrenal glands was significantly higher in the saline group after 1 h. In conclusion, peritoneal lavage prevented the increase in heart rate and the development of a significant decrease in pancreatic blood flow in experimental hemorrhagic pancreatitis. The significance of these findings remains to be further evaluated.