A comparative study of the effects of insulin/glucagon infusions, parenteral amino acids and high dose corticosteroids on survival in a rabbit model of acute fulminant hepatitis
✍ Scribed by Gerald Y. Minuk.M.D.; Thomas A. Sherman; Eldon A. Shaffer; Seamus K. Kelly
- Publisher
- John Wiley and Sons
- Year
- 1986
- Tongue
- English
- Weight
- 734 KB
- Volume
- 6
- Category
- Article
- ISSN
- 0270-9139
No coin nor oath required. For personal study only.
✦ Synopsis
Acute fulminant hepatitis was induced in 55 healthy adult male rabbits with the potent hepatotoxin galactosamine hydrochloride (3.75 mmoles per kg i.v.). Control rabbits (n = 27) were divided into three groups: Group I (n = 10) underwent sham surgery for placement of an indwelling central venous catheter; Group I1 (n = 9) received 5% dextrose and water via an indwelling central venous catheter, and Group I11 (n = 8 ) received daily intramuscular injections of 0.9% sodium chloride.
Treated rabbits (n = 28) also consisted of three groups:
Group IV (n = 9) received 12-hr intravenous infusions of insulin (0.029 units per kg per hr) and glucagon (2.86 fig per kg per hr) daily; Group V (n = 10) received a continuous infusion of parenteral amino acids (Travasop), and Group VI (n = 9) received daily intramuscular methylprednisolone (0.69 mg per kg). In each case, treatment was initiated 16 hr following galactosamine injection. Serum aminotransferase activity was determined on Days 0, 1 , 4 and 10 of the 10-day study. Liver histology was obtained immediately after death and graded under code on a scale of 1 to 4 for severity of hepatitis. Rabbits surviving 10 days were sacrificed on Day 10 for histologic examination.
The extent of galactosamine-induced hepatic injury was similar in all six groups as manifest by peak mean SGPT (range: 2,662 to 3,568 IU per liter), SGOT (range: 4,435 to 5,625 IU per liter) levels and hepatic histologic findings. The overall survival rate in controls was 6/27 (22%); in insulin/glucagon-treated animals 219 (22%), and in the amino acid-treated group 2/10 (20%). The corticosteroid-treated group, however, had significantly improved survival: 619 (6770, p < 0.05, Fisher's exact test). No difference between groups was observed in the mean survival times of animals dying prior to Day 10 (range: 30.7 * 2.7 -55.5 2 13.0 hr, mean f S.E., p > 0.05). In conclusion, the results of this study indicate that in this animal model of acute fulminant hepatitis and with these doses, insulin/glucagon infusions and