LOCAL AND SYSTEMIC EFFECTS OF HYPERTONIC SOLUTION (NaCl 7.5%) IN EXPERIMENTAL ACUTE PANCREATITIS.
Severe acute pancreatitis (AP) is characterized by hemodynamic alterations and a systemic inflammatory response, leading to a high mortality rate. Treatment of hemorrhagic shock with hypertonic saline solutions significantly reduces mortality through an improvement in the hemodynamic conditions and possibly by an anti-inflammatory effect. Therefore, hypertonic solutions could be effective in AP. Methods: We used male Wistar rats. AP was induced by intraductal 2.5% taurocholate injection. The animals were divided in 4 groups: C(n=20): control (without AP), NT(n=58): AP, not treatment, NS (n=58): received 34ml/kg of normal saline solution (NaCl 0.9%) i.v., 1 hour after AP, and HTS(n=55): 4ml/Kg of hypertonic saline solution (NaCl 7.5%) i.v., 1 hour after AP. Mean arterial blood pressure (MAP) was recorded at 0 and 2,4,24, and 48 hours after AP. After induction of AP animals were sacrificed at 2,12,24, and 48 hours to determined: IL-6, IL-10, pancreatic tissue culture and histological analysis, oxidation and phosphorylation of liver mitochondria, pulmonary myeloperoxidase activity (MPO) and mortality study. Results: In the groups NS and NT was observed a significant decrease of MAP 48h after AP (NS: 91±3mmHg) and (NT:89±3mmHg) compared to baseline (C:105 ±2mmHg) and in HTS group (102 ± 2mmHg). (p<0.05). In animals of group NT, NS and HTS, serum IL-6 and IL-10 levels were significantly higher in 2h after AP when compared to the control group. However the HTS group had a significantly lower in 2 and 12 h after AP when compared to NS and NT groups (p<0.05). The differences in histologic findings between groups were not statistically significant. After 48h of AP a significant reduction in RCR was observed in animals of group NT and NS when compared to HTS and control group (p<0.05). In group HTS it was observed a decrease of MPO activity at 24h when compared to NT and NS groups (p<0.05). A significant reduction of pancreatic infection was observed in animals of group HTS (p<0.05) and a significant reduction on mortality was observed in HTS (0/14) compared to NS (6/17-35%) and C (7/20-35%). Conclusion: Administration of HTS in experimental acute pancreatitis: attenuates hemodynamic alterations, decreases inflammatory cytokines, diminishes systemic lesions, prevents pancreatic infection and reduces the moratlity rate.
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