INFLUENCE OF CERULETID ON GALLBLADDER CONTRACTION - A POSSIBLE PROPHYLAXIS OF ACUTE ACALCULOUS CHOLECYSTITIS IN INTENSIVE-CARE PATIENTS

The purpose of this study was to investigate the utility of repeated a pplications of ceruletid to reduce gallbladder volume and its feasibil ity as a means of prophylaxis of acute acalculous cholecystitis in int ensive care patients. First, a dose-response curve of ceruletid was ob tained in 20 mechanically ventilated patients of a surgical intensive care unit (SICU) not receiving enteral nutrition. An effective dose of ceruletid, defined by a 50% reduction of gallbladder volume was estab lished and subsequently studied in 40 mechanically ventilated SICU pat ients on total parenteral nutrition in a prospective, randomized, cont rolled, triple-blind trial. Gallbladder volume, sludge formation and s ide effects were evaluated. A dose of 1.5 mu g/kg body weight ceruleti d was established as the effective dose, causing 50% reduction of gall bladder volume in all patients studied and reduction of gallbladder sl udge in 95%. In 67.5% of patients side effects were observed, requirin g therapeutic intervention in 68%. It is concluded that ceruletid is e ffective in stimulating gallbladder contraction and reducing sludge fo rmation in severely ill patients on intensive care units. Its routine use as prophylaxis of acute acalculous cholecystitis, however, may be limited by the nature, severity and frequency of side effects.