Acute effects of pantoprazole infusion on hepatic artery and portal flow hemodynamics in portal hypertensive rabbits

Purpose: The aim of our study is to compare the acute effects of somatostatin and pantoprazole infusion on portal vein pressure, hepatic artery pressure, systemic arterial pressure and heart rate in rabbits which partial portal vein ligation have been done.Materials and Methods: Subjects were randomly separated into three groups. Sham operation in the first group and partial portal vein ligation in the second and third group was done. Four weeks later following a laparotomy under anesthesia femoral artery, portal vein and hepatic artery were cannulated, systemic arterial pressure (SAP), heart rate (HR), hepatic artery pressure (HAP) and portal vein pressure (PVP) were monitorized and measured. After basal measurements were done, i.v. somatostatin to second group (1-1,5 mcg/kg/h i.v. bolus followed by 1-1,5 mcg/kg/h i.v. infusion) and i.v pantoprazole to third group (1 mcg/kg i.v. bolus followed by 0,1 mcg/kg/h i.v. infusion) were given and measurements were repeated at 30th minute. The measurements prior to and at 30th minute after infusion were compared. In sham operated group, PVP, HAP, SAP and HR were measured, serum physiologic infused (1 ml/kg/h) and the same measurements were done at 30th minute of infusion.Results: Portal vein pressure measurements of pantoprazole, somatostatin and sham groups were compared. In pantoprazole (11,4 mmHg) and somatostatin (12,2 mmHg) group, portal vein pressure was found to be significantly high compared to sham group (7,7 mmHg) (p<0,005). Therefore it was shown that both in PPI and somatostatin groups portal hypertension occured.The values prior to and after pantoprazole infusion were compared and it was found that it didn?t effect mean arteriel pressure but reduced significantly HR, HAP and PVP.With somatostatin infusion statistically significant reduction in HAP and PVP no difference in mean SAP was noted (p=0,77).The reduction in portal vein pressure was more pronounced in the somatostatin group compared to the pantoprazole group and this was significant (p=0,014). Although pantoprazole has reduced the PVP, this effect didn?t as strong as SMS.In the sham operated group, to excluse the possible placebo effect serum physiologic infusion was done; basal and 30th minute measurements were compared. No statistically significant difference was found.Conclusion: Although pantoprazole is not as potent as somatostatin, it reduces PVP significantly. Being started to infuse in upper GİS bleeding with unknown etiology pantoprazole, especially in cirrhotic patients by reducing portal hypertension in addition to reducing gastric pH may provide additional benefit in bleeding control. Our study may help the future human studies which focused on pantoprazole?s effects on portal hemodinamics.