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Effects of thoracic epidural anesthesia on survival and microcirculation in severe acute pancreatitis: a randomized experimental trial

INTRODUCTION: Severe acute pancreatitis is still a potentially life threatening disease with high mortality. The aim of this study was to evaluate the therapeutic effect of thoracic epidural anaesthesia (TEA) on survival, microcirculation, tissue oxygenation and histopathologic damage in an experime...

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Autores principales: Bachmann, Kai A, Trepte, Constantin JC, Tomkötter, Lena, Hinsch, Andrea, Stork, Jan, Bergmann, Wilken, Heidelmann, Lena, Strate, Tim, Goetz, Alwin E, Reuter, Daniel A, Izbicki, Jakob R, Mann, Oliver
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056310/
https://www.ncbi.nlm.nih.gov/pubmed/24314012
http://dx.doi.org/10.1186/cc13142
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author Bachmann, Kai A
Trepte, Constantin JC
Tomkötter, Lena
Hinsch, Andrea
Stork, Jan
Bergmann, Wilken
Heidelmann, Lena
Strate, Tim
Goetz, Alwin E
Reuter, Daniel A
Izbicki, Jakob R
Mann, Oliver
author_facet Bachmann, Kai A
Trepte, Constantin JC
Tomkötter, Lena
Hinsch, Andrea
Stork, Jan
Bergmann, Wilken
Heidelmann, Lena
Strate, Tim
Goetz, Alwin E
Reuter, Daniel A
Izbicki, Jakob R
Mann, Oliver
author_sort Bachmann, Kai A
collection PubMed
description INTRODUCTION: Severe acute pancreatitis is still a potentially life threatening disease with high mortality. The aim of this study was to evaluate the therapeutic effect of thoracic epidural anaesthesia (TEA) on survival, microcirculation, tissue oxygenation and histopathologic damage in an experimental animal model of severe acute pancreatitis in a prospective animal study. METHODS: In this study, 34 pigs were randomly assigned into 2 treatment groups. After severe acute pancreatitis was induced by intraductal injection of glycodesoxycholic acid in Group 1 (n = 17) bupivacaine (0.5%; bolus injection 2 ml, continuous infusion 4 ml/h) was applied via TEA. In Group 2 (n = 17) no TEA was applied. During a period of 6 hours after induction, tissue oxygen tension (tpO(2)) in the pancreas and pancreatic microcirculation was assessed. Thereafter animals were observed for 7 days followed by sacrification and histopathologic examination. RESULTS: Survival rate after 7 days was 82% in Group 1 (TEA) versus 29% in Group 2: (Control) (P <0.05). Group 1 (TEA) also showed a significantly superior microcirculation (1,608 ± 374 AU versus 1,121 ± 510 AU; P <0.05) and tissue oxygenation (215 ± 64 mmHg versus 138 ± 90 mmHG; P <0.05) as compared to Group 2 (Control). Consecutively, tissue damage in Group 1 was reduced in the histopathologic scoring (5.5 (3 to 8) versus 8 (5.5 to 10); P <0.05). CONCLUSIONS: TEA led to improved survival, enhanced microcirculatory perfusion and tissue oxygenation and resulted in less histopathologic tissue-damage in an experimental animal model of severe acute pancreatitis.
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spelling pubmed-40563102014-06-14 Effects of thoracic epidural anesthesia on survival and microcirculation in severe acute pancreatitis: a randomized experimental trial Bachmann, Kai A Trepte, Constantin JC Tomkötter, Lena Hinsch, Andrea Stork, Jan Bergmann, Wilken Heidelmann, Lena Strate, Tim Goetz, Alwin E Reuter, Daniel A Izbicki, Jakob R Mann, Oliver Crit Care Research INTRODUCTION: Severe acute pancreatitis is still a potentially life threatening disease with high mortality. The aim of this study was to evaluate the therapeutic effect of thoracic epidural anaesthesia (TEA) on survival, microcirculation, tissue oxygenation and histopathologic damage in an experimental animal model of severe acute pancreatitis in a prospective animal study. METHODS: In this study, 34 pigs were randomly assigned into 2 treatment groups. After severe acute pancreatitis was induced by intraductal injection of glycodesoxycholic acid in Group 1 (n = 17) bupivacaine (0.5%; bolus injection 2 ml, continuous infusion 4 ml/h) was applied via TEA. In Group 2 (n = 17) no TEA was applied. During a period of 6 hours after induction, tissue oxygen tension (tpO(2)) in the pancreas and pancreatic microcirculation was assessed. Thereafter animals were observed for 7 days followed by sacrification and histopathologic examination. RESULTS: Survival rate after 7 days was 82% in Group 1 (TEA) versus 29% in Group 2: (Control) (P <0.05). Group 1 (TEA) also showed a significantly superior microcirculation (1,608 ± 374 AU versus 1,121 ± 510 AU; P <0.05) and tissue oxygenation (215 ± 64 mmHg versus 138 ± 90 mmHG; P <0.05) as compared to Group 2 (Control). Consecutively, tissue damage in Group 1 was reduced in the histopathologic scoring (5.5 (3 to 8) versus 8 (5.5 to 10); P <0.05). CONCLUSIONS: TEA led to improved survival, enhanced microcirculatory perfusion and tissue oxygenation and resulted in less histopathologic tissue-damage in an experimental animal model of severe acute pancreatitis. BioMed Central 2013 2013-12-05 /pmc/articles/PMC4056310/ /pubmed/24314012 http://dx.doi.org/10.1186/cc13142 Text en Copyright © 2013 Bachmann et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Bachmann, Kai A
Trepte, Constantin JC
Tomkötter, Lena
Hinsch, Andrea
Stork, Jan
Bergmann, Wilken
Heidelmann, Lena
Strate, Tim
Goetz, Alwin E
Reuter, Daniel A
Izbicki, Jakob R
Mann, Oliver
Effects of thoracic epidural anesthesia on survival and microcirculation in severe acute pancreatitis: a randomized experimental trial
title Effects of thoracic epidural anesthesia on survival and microcirculation in severe acute pancreatitis: a randomized experimental trial
title_full Effects of thoracic epidural anesthesia on survival and microcirculation in severe acute pancreatitis: a randomized experimental trial
title_fullStr Effects of thoracic epidural anesthesia on survival and microcirculation in severe acute pancreatitis: a randomized experimental trial
title_full_unstemmed Effects of thoracic epidural anesthesia on survival and microcirculation in severe acute pancreatitis: a randomized experimental trial
title_short Effects of thoracic epidural anesthesia on survival and microcirculation in severe acute pancreatitis: a randomized experimental trial
title_sort effects of thoracic epidural anesthesia on survival and microcirculation in severe acute pancreatitis: a randomized experimental trial
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056310/
https://www.ncbi.nlm.nih.gov/pubmed/24314012
http://dx.doi.org/10.1186/cc13142
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