Inibição da guanilato ciclase pelo azul de metileno no choque circulatório causado por pancreatite aguda necrosante: Uma palavra de cuidado embasada em modelo suíno

Translated title of the contribution: Guanylate cyclase inhibition by methylene blue in circulatory shock caused by acute necrotizing pancreatitis: A word of caution based on a porcine model

Caroline Floreoto Baldo, Verena Kise Capellini, Andrea Carla Celotto, Fabiane Sônego, Luis Fernando Tirapelli, Marcelo Batalhão, Evelin Capellari Cárnio, José Sebastião dos Santos, Paulo Roberto Barbosa Evora

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

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.

Translated title of the contributionGuanylate cyclase inhibition by methylene blue in circulatory shock caused by acute necrotizing pancreatitis: A word of caution based on a porcine model
Original languagePortuguese
Pages (from-to)480-489
Number of pages10
JournalRevista do Colegio Brasileiro de Cirurgioes
Volume40
Issue number6
DOIs
StatePublished - Nov 2013

Keywords

  • Free radicals methylene blue
  • Guanylate cyclase
  • Nitric oxide
  • Pancreatitis

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