The Action of the Basic Trypsin Inhibitor, Trasylol, on Shock Resulting from Occlusion of the Superior Mesenteric Artery: Experimental Study
The action of the enzymic inhibitor Trasylol upon shock from occlusion of the superior mesenteric artery (SMA) in forty-six dogs, arranged in four groups, has been studied. In Group A of controls (thirteen dogs) an intestinal ischaemia of 31/2 hours duration was produced. After removal of the arterial occlusion, shock was produced in eleven dogs, which died within the first 24 hours. A frequent finding at autopsy was haemorrhagic infiltration of the intestinal mucosa and the occurrence of haemorrhagic contents in the intestinal lumen. Histologically, frequent findings were capillary distension and hyperaemia, perivascular haemorrhagic infiltration and superficial or total necrosis of the intestinal mucosa. In Group B (ten dogs), Group C (ten dogs) and Group D (thirteen dogs), the experimental arrangement was similar to that in Group A, except for Trasylol administration. An infusion of Trasylol, 30,000 units/kg body-weight intravenously 10 minutes before occlusion of the artery was given to the experimental animals of Group B, while a second infusion of 30,000 units/kg body-weight into the superior mesenteric artery or intravenously was given to the experimental animals of Group C and Group D, respectively, 10 minutes before the removal of arterial occlusion. The results in Group B were a little better in comparison with those of the controls, but the differences were not statistically significant. On the contrary, significant differences were seen with Group C and Group D. Shock was produced in a small number of experimental animals. Over 50% of the experimental animals survived. The intestinal alterations seen at autopsy and histologically were about the same as in the control group, but at a clearly lower frequency. It is concluded that the administration of enzymic inhibitors may eventually have a practical application in situations of re-establishment of mesenteric circulation after its acute interruption.