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It has been shown in this laboratory that the intravenous infusion of pancreatic juice in dogs is followed by temporary arterial hypotension.1,2 The drop in blood pressure is more pronounced and prolonged if the trypsinogen of the pancreatic juice has been enterokinase-activated into trypsin before its infusion. It has been postulated that the trypsin, and perhaps other factors in the pancreatic juice, activate kinin precursors in the serum to produce vasodilatation. Aprotinin (Trasylol), as a trypsin and possibly kallikrein inhibitor, when added to the pancreatic juice prior to intravenous infusion of the mixture, did not significantly ameliorate this hypotensive response. Similarly, heating of the pancreatic juice before its intravenous infusion in order to destroy any enzyme protein activity reduced but did not abolish the hypotensive response.
An ultimate aim of these studies has been to elucidate the cause of hypotension in the patient with severe, acute pancreatitis.
Yacoub RS, Appert HE, Howard JM. Intra-arterial Perfusion of Pancreatic Juice in the Hind Limb of Dogs: Effects on the Peripheral Vascular Resistance. Arch Surg. 1969;99(1):40–46. doi:10.1001/archsurg.1969.01340130042008
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