Acute lung injury in two experimental models of acute pancreatitis: Infusion of saline or sodium taurocholate into the pancreatic duct

Objective: To compare acute pulmonary changes secondary to sodium taurochol ate hemorrhagic pancreatitis with those changes secondary to a less severe pancreatitis induced by saline infusion into the biliopancreatic duct. Design: Prospective, randomized controlled trial. Setting: University pulmonary laboratory, Subjects: A total of 110 male Wistar rats. Interventions: Pancreatitis was induced by either 0.5 mL. of a 4% solution of sodium taurocholate (TAU group) or 0.5 mt of normal saline (SAL group) i njection into the biliopancreatic duct. Data were compared with data from c ontrol (sham-operated) animals (SHAM group). Measurements and Main Results:The severity of pancreatic and pulmonary inju ries was evaluated 1, 3, and 8 days after the induction of acute pancreatit is by morphometric and pulmonary mechanical studies. Biliopancreatic duct p ressure was measured during infusion of solutions in SAL and TAU groups. SA L and TAU groups developed an intense necrohemorrhagic pancreatitis on day 1 without differences in biliopancreatic duct pressures (134.0 +/- 45.1 cm H2O vs. 123.3 +/- 23.4 cm H2O). Acute pancreatic lesions were still intense on day 3 in the TAU group only. Pulmonary resistance in SAL and TAU groups was significantly greater than in the SHAM group on day 3 only. On day 1, there was an increase in intraalveolar edema in both groups (p < .02), Ther e was an increase in polymorphonuclear cells in alveolar septa on day 1 onl y in the TAU group (p < .001). In contrast, both experimental groups presen ted greater values of PMN cells on day 8 compared with the SHAM group (p < .001), Both groups with pancreatitis showed an increase in alveolar distent ion and collapse on day 1 that persisted only in the TAU group on days 3 an d 8. No deaths were observed in the control (SHAM) group. In contrast, the SAL group had lower mortality than the TAU group in the first two days (17% and 52%, respectively, p = .03). Conclusion: High-pressure infusion of normal saline into the biliopancreati c duct of rats results in significant pancreatic and lung alterations. Thes e changes are worse in the presence of sodium taurocholate.