INTERVENTIONAL THERAPY OF NONOCCLUSIVE ME SENTERIAL ISCHEMIA WITH CAPTOPRIL - AN EXPERIMENTAL ANIMAL STUDY

Purpose: To clarify whether in nonocclusive mesenterial disease the ex tent of damage to the intestinal wall can be limited by local intraart erial application of Captopril. Method: Producing shock by means of pe ricardial tamponade in 18 piglets. Examination of three groups: Intraa rterial application of Captopril at the beginning of the shock phase ( n=6) or administration one hour after the beginning of the shock phase (n=6), as well as a control group (n=6). Analysis of clinical patholo gy (laboratory chemistry) and haemodynamic parameters over a test peri od of 4 hours and histological preparation of resected segments of the small intestine. Results: The initiation of therapy at the beginning of the shock improved the blood supply of the intestinal wall (measure d by means of laser sonography in relative now units RFU) from 226 RFU to 303 RFU; the rise in lactate from 2.7 to 3.6 mmol/l was significan tly less (p=0.05) than for the control group (from 3.1 to 11.5 mmol/l) . The frequency and severity of the histological changes that are typi cal for ischaemia were less pronounced. If therapy was started only af ter a one-hour shock phase, this effect was no longer noticeable (rise in lactate from 5 to 9.5 mmol/l, intestinal wall blood flow from 168 to 170 RFU).Conclusion: Intraarterial administration of Captopril can reduce the extent of damage in nonocclusive mesenterial ischaemia (non occlusive disease) if therapy is initiated early enough.