胰岛分离、纯化制备的改进

目的 探讨大型哺乳动物胰岛机械化大量分离、纯化的方法,为人类胰岛移植物的大量制备摸索创造条件.方法 应用改进的机械化胰岛分离、纯化系统,用HCA和UW液顺序原位灌洗犬胰腺,主副胰管插管,4℃胶原酶-V(1.5 g/L)+胰酶抑制剂pefabloc(0.4 mmol/L)灌注后,Ricordi-Chamber消化罐消化,4℃COBE2991连续密度梯度离心纯化,测定胰岛当量(IEQ)、胰岛纯度及存活率、胰岛素及C-肽的释放量、培养24 h后光镜及电镜观察.结果 胰腺消化时间为(25.0±6.0)min,胰岛外分泌腺包裹率为(9.4±2.4)%,消化后胰岛收获量为(17.2±3.6)×104IEQ/每个胰腺,纯化后胰岛收获量为(8.3±2.0)×104IEQ/每个胰腺,胰岛纯度为(89.7±3.5)%.纯化胰岛体外低糖与高糖刺激下胰岛索分泌量及C-肽的释放量良好,培养24 h后形态结构及功能正常.结论 本实验室改进的胰岛机械分离方法及各设备运行可靠,获得的胰岛形态功能良好,可望用于临床人类胰岛的大量制备.     

不同器官保存液对成人胰岛分离、纯化及功能的影响

目的探讨不同器官保存液保存胰腺对胰岛分离、纯化及功能的影响。方法以成人胰腺为研究对象,分别以高渗枸橼酸钾溶液(HCA液)与威斯康新大学器官保存液(UW液)灌洗、保存胰腺,进行胰岛分离及纯化,比较两组分离、纯化后收获的胰岛数及胰岛当量数(IEQ),并在体外评价其功能。结果两组在胰腺重量、热缺血时间、冷缺血时间没有明显差异的情况下,胰腺分离、纯化后所获得的胰岛数及胰岛当量数的差异无显著性(P>0.05),纯化后的胰岛细胞在体外低糖与高糖刺激下,其胰岛素的分泌量及C肽的释放量的差异也无显著性(P>0.05);两个组胰岛细胞的活率均在85%以上。结论在胰岛移植中,可以使用HCA液作为胰腺保存液。     

大鼠胰岛的分离纯化方法改进与功能鉴定

目的 通过改进胰腺消化和分离的技术条件,提高成年大鼠胰岛分离纯化产率和质量. 方法 用胶原酶Ⅺ液灌注消化成年SD大鼠胰腺,对胰岛分离纯化方法加以改进:以 4 种比重的 Euro- Ficoll (F1∶D=1.132,F2∶D=1.108,F4∶D=1.069) 和 Hank's 液(F5∶D=1.023) 不连续密度梯度离心,以离心半径 15 cm,2 000 r/min 于4℃缓慢升降离心 20 min,收集位于F1 和 F2界面的胰岛.双硫腙特异染色法鉴定胰岛纯度;二醋酸酯荧光素/碘化丙啶染色法计算胰岛成活率;放射免疫分析法检测葡萄糖刺激的胰岛素分泌量,计算刺激指数.将胰岛当量(islets equivalent quantity,IEQ) 为 1000 的胰岛移植于同品系糖尿病大鼠肾包膜下,9d 内隔日观察动物血糖的变化,评价胰岛功能.比较分离条件优化前后收获胰岛的产率和质量. 结果 改进纯化方法后每只大鼠胰岛收获量为(920±122) IEQ,胰岛纯度> 90%,胰岛细胞成活率为 91%±2%.胰岛细胞功能良好,在低糖和高糖刺激后培养液中胰岛素浓度分别为(18.25±0.32) mU/L 和(36.70±3.57)mU/L,刺激指数为 2.01±0.15.1000 IEQ 胰岛移植于糖尿病大鼠肾包膜下,观察期内可维持动物血糖水平正常. 结论 改进后的胶原酶灌注消化和不连续梯度离心方法提高了胰岛的产率,保证了胰岛的高纯度及高成活率.     

机械分离成人尸体胰腺提高胰岛数量和质量

目的通过机械分离胰腺的方法,提高成人胰岛数量和质量。方法切取8个成人尸体胰腺,并保存于4℃UW液中。首先经主胰管插管灌注复合胶原酶溶液,使胰腺膨胀,然后将胰腺剪切成5~8块,放入Ricordi室中,于37℃下机械震荡消化。收集的胰岛溶于100mlUW液中,放置30min。先将Ficoll液泵入COBE2991细胞分离仪中,然后泵入UW/胰岛制剂,最后加入M199液冲洗。收集纯化的胰岛,计算胰岛当量(IEQ)和纯度,检测胰岛的活性。结果热缺血时间为0~1min,冷缺血时间0.5~4h。纯化前收集的胰岛数量平均为(376.7±50.2)×103IEQ,纯化后为(378.6±56.7)×103IEQ;胰岛收获率平均为(86.8±9.4)%,镶嵌的胰岛平均占(11.0±2.7)%;收获的胰岛纯度平均为(88.3±5.1)%;经AO-PI染色后检测胰岛的活度为(91.3±7.8)%。胰岛素分泌指数平均为5.87±0.81。结论通过机械分离胰腺的方法,可以获得更多的胰岛数量和更高的胰岛活性,适合用于临床移植。     

猪胰岛的分离与纯化

目的 探索大规模猪胰岛细胞分离纯化的方法.方法 联合器官切取,胶原酶P主胰管灌注,COBE2991细胞分离机及HCA-Ficoil纯化猪胰岛细胞.通过双硫腙(DTZ)染色,倒置显微镜下计数胰岛细胞的数量和纯度,胰岛素释放试验检测胰岛细胞的分泌功能.结果 消化后平均每条胰腺可平均获得(275 000±20 895)胰岛细胞当量(IEQ),纯化后平均为(230 350±26 679)IEQ,平均每克胰腺组织可获得(2710±229)IEQ,纯化后胰岛细胞平均纯度为(50.2±1.95)%.纯化后的胰岛细胞对胰岛素释放刺激反应良好,高糖(16.7 mmol/L)时胰岛素的释放量为低糖(3.3 mmol/L)时的4.74倍(P≤0.001).结论 成功建立了猪胰岛细胞分离、纯化的方法,纯化的猪胰岛细胞具有良好的生物活性.     

不同胶原酶消化对大鼠胰岛的纯化和获得率的影响

目的 比较不同胶原酶消化大鼠胰腺的效果,选择消化效果较好的胶原酶.方法 采用随机数字表法将SD大鼠分为2组,胶原酶P组大鼠胰腺使用1 mg/ml的胶原酶P液进行消化,Ⅴ型胶原酶组大鼠胰腺使用1 mg/ml的Ⅴ型胶原酶进行消化.胰腺消化后,对获得的两组大鼠胰岛进行纯化、培养.采用双硫腙染色于倒置显微镜下计数纯化前后获得的两组全部胰岛数量,并计算胰岛当量(IEQ);采用吖啶橙和碘丙啶双色荧光染色,于荧光显微镜下计数纯化后胰岛的活率;两组大鼠胰岛经纯化、培养2d后进行胰岛素释放试验,观察两组胰岛的功能.结果 纯化前,两组间每个大鼠胰腺获得的胰岛数量的差异无统计学意义(P＞0.05);但两组间IEQ的差异有统计学意义(P＜0.05);经纯化后,Ⅴ型胶原酶组和胶原酶P组每个大鼠胰腺获得的胰岛数量分别为485±113和643±82,IEQ分别为674±157和989±126,两组间胰岛数量和IEQ的比较,差异均有统计学意义(P＜0.05).Ⅴ型胶原酶组和胶原酶P组大鼠胰岛经纯化后,其活率分别为(96.13±1.13)％和(96.38±0.92)％,两组比较,差异无统计学意义(P＞0.05).胰岛素释放试验结果显示,在低糖或高糖刺激下,两组间大鼠胰岛功能的差异均无统计学意义(P＞0.05).结论 两种胶原酶均适用于大鼠胰腺的消化,但胶原酶P消化效果较Ⅴ型胶原酶稳定,且胰岛获得率也较高.     

成人胰岛大容量分离技术的改进及胰岛功能检测

目的 通过对人胰岛分离技术的改进以获得大量高活力胰岛并检测其功能,为利用同种异体胰岛移植治疗1型和部分2型糖尿病提供理论依据和技术基础。方法 采用改良的自动分离技术连续分离28例人胰岛,然后用连续性密度样度离心法纯化胰岛。胰岛收获量以国际标准的胰岛当量(islet equivalent,IEQ)表示。胰岛功能的测定分别为体外测定胰岛的胰岛素／DNA比率;静止葡萄糖刺激试验(SGS)及将胰岛移植至糖尿病裸小鼠的体内胰岛功能鉴定并随后进行腹腔糖耐量试验,连续测定移植鼠血糖水平及其体内C肽浓度。结果 28例成人胰腺分离的胰岛收获量为5000～1030000IEQ／胰腺,平均为291635IEQ／胰腺,前13例平均每个胰腺收获49123IEQ,平均每克组织收获846IEQ。平均纯度为87％,随着技术的改进后15例的分离结果则分别为：平均每个胰腺501813IEQ,平均每克组织7003IEQ,平均纯度89％。体外胰岛素刺激试验结果表明分离纯化后的人胰岛有正常功能,将12次分离得到的胰岛分别移植至34只糖尿病裸鼠肾包膜下,其中29只糖尿病裸鼠于12h内血糖恢复正常且糖耐量试验接近正常鼠,血中C肽水平亦接近正常鼠。结论 采用改进的人胰岛分离方法,可以获得大量高活力的具有正常功能的胰岛,为同种异体胰岛移植用于临床奠定了必要的实验基础。     

成人胰岛细胞的分离

目的　探讨成人胰岛细胞的分离及胰腺冷缺血时间与胰岛细胞活率的关系。方法　采取胰、肾联合切取 ,经腹主动脉插管 ,用自制的灌注器以高渗枸橼酸盐嘌呤溶液 (HC A液 ) 15 0 0～2 0 0 0ml进行原位灌洗。将肾与胰腺、十二肠、脾分离 ,采用胶原酶P消化胰腺 ,分离并纯化胰岛细胞 ,以双硫腙及丫腚橙染色 ,测定所得到的胰岛细胞的纯度及活率。结果　胰腺的冷缺血时间为 2 .5～ 8h ,温缺血时间为 0～ 3min。胰岛收获量为 (2 .38± 0 .6 7)× 10 3 IEQ/g ,纯化后胰岛细胞的活率为 19%～ 83% ,冷保存指数 (或输注指数 )为 9.8～ 6 6 .4。胰岛细胞的活率与胰腺的冷缺血时间呈负相关 ,冷保存指数和胰岛细胞活率呈负相关。结论　以高渗枸橼酸盐嘌呤溶液灌洗、胶原酶P消化胰腺所得到的胰岛细胞活率高 ,但胰腺的冷缺血时间不宜超过 5h。     

热缺血时间对大鼠胰岛结构和功能的影响

目的 探讨胰腺热缺血时间对胰岛形态和功能的影响。方法 以Lewis大鼠的胰腺为研究对象，分别在大鼠被处死后立即、25min后及30min后以胶原配灌注，然后分离、纯化胰岛，观察各组所得胰岛的形态、活性、胰岛当量数(IEQ)与功能。结果 各组均可获得形态完好的胰岛，胰岛细胞活率在85％以上；各组IEQ的差异元显著性；热缺血时间25min组与立即灌注组相比，纯化后的胰岛细胞在低糖与高糖刺激下，胰岛素分泌量的差异元显著性，而热缺血时间30min组与立即灌注组相比，胰岛素的分泌能力显著降低(P＜0．01)。结论 热缺血时间不超过25min时，分离、纯化后得到的胰岛在结构与功能方面的改变不显著，若热缺血时间延长到30min时，胰岛功能出现减退。     

家兔胰岛分离纯化方法的改进

目的介绍一种新的家兔胰岛分离纯化方法并进行纯化后胰岛的外观、活性和胰岛细胞团表面结构等质量分析。方法雄性日本大耳白,采用2 mg/m L胶原酶V逆行胰管灌注和消化,并用Hanks液洗涤,用Histopaque-1119、Histopaque-1077密度梯度离心进行胰岛纯化,DTZ、FD-PI染色鉴定胰岛纯度和活性,扫描电镜观察纯化后胰岛表面结构。结果家兔胰管开口于小肠,纯化得到家兔胰岛外形圆整,纯度90%,活性(87.4±5.9)%,纯化前胰岛当量为(1 874.8±464.5)IEQ,纯化后胰岛当量为(1 254.8±235.8)IEQ;扫描电镜结果显示胰岛细胞团表面有被膜,但部分胰岛被膜被消化。结论采用此方法可快速得到纯度高、活性好且结构完整的家兔胰岛,为进一步进行家兔胰岛体外质量及体内移植研究奠定了基础。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Is the recovery profile of mivacurium independent of the rate of decay of its plasma concentration in patients with normal plasma cholinesterase activity?

Background: The duration of action of muscle relaxants is poorly correlated to the rate of decay of their plasma concentration. The plasma concentration of mivacurium may rapidly decrease below its active concentration because of the extensive hydrolysis of mivacurium. By inflating a tourniquet on one upper limb for 3 min after the administration of atracurium, mivacurium or vecuronium, we studied the influence of the initial decline of their plasma concentration on their effect. Methods: In 50 patients anaesthetised with thiopental, isoflurane and fentanyl, the effect of bolus doses of 0.15 or 0.25 mg . kg^?1 mivacurium (MIV 15, MIV 25), 0.3 or 0.5 mg . kg^?1 atracurium (ATR 30, ATR 50) and 0.06 or 0.1 mg . kg^?1 vecuronium (VEC 06, VEC 10) were measured on both arms (evoked response of the adductor pollicis to train-of-four stimulation every 12 s), a tourniquet being applied on one arm just before and during 3 min after the muscle relaxant bolus. Results: Tourniquet inflation of 3 min almost abolished the neuromuscular effect of mivacurium. In the vecuronium groups and in the ATR 50 group, tourniquet inflation did not modify the maximum degree of depression of the twitch response. Also, the duration of action of vecuronium was unaffected by the tourniquet. In the ATR 30 group, times to return of the twitch response to 25% (duration 25%) and 75% (duration 75%) of control response were significantly shorter in the cuffed arm, 23 min vs 27 min, and 41 min vs 45 min, respectively. In the ATR 50 group, only duration 25% was significantly shorter in the cuffed arm (41 min vs 45 min). Conclusion: The results suggest that the rate of decline of the plasma concentration of mivacurium is so rapid, that a very low and almost clinically ineffective concentration is present as soon as 3 min after its administration. The results also indicate that the recovery from a mivacurium-induced neuromuscular blockade is not influenced by the rate of decay of its plasma concentration in patients with genotypically normal plasma cholinesterase.     

Membranes in Artificial Organs

Abstract: Membrane processes play a pivotal and enabling role in modern replacement therapy for acute and chronic organ failure and in the management of immunologic diseases. In fact, virtually all contemporary extracorporeal blood purification methods employ membrane devices, and the next generation of artificial organs and tissue engineering therapies are almost certain to be similarly grounded in membrane technology. In this short essay, we comment on the similarities and differences among synthetic membranes and their natural counterparts and also provide a critical overview of the demographics and technology of hemodialysis, hemofiltration, apheresis, oxygenation, and emerging membrane technologies and applications.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.