Comparison of an intravenous selective mesenteric vasodilator with intraarterial papaverine in experimental nonocclusive mesenteric ischemia.

Acute nonocclusive mesenteric ischemia was produced in dogs anesthetized with pentobarbital by reversible pericardial tamponade, which reduced cardiac output and mesenteric blood flow by approximately 42% and 53%, respectively. Papaverine, infused into the cephalic (superior) mesenteric artery at an average dose of 100 micrograms/kg X min, was completely effective in restoring mesenteric blood flow and correcting altered intestinal oxygen kinetics. However, the same dose of papaverine given intravenously to other dogs was ineffective in correcting the deranged hemodynamics and oxygen kinetics. Larger doses of intravenous papaverine returned mesenteric blood flow toward control values but caused systemic arterial hypotension. In comparison, synthetic urotensin I, a highly selective mesenteric vasodilator peptide, produced results identical to those produced by intraarterial papaverine, even though it was given intravenously in small doses (average dose: 13 ng/kg . min). Moreover, it produced no systemic effects. These results suggest that intravenous urotensin I is as effective as intraarterial papaverine in a model of severe mesenteric ischemia, and that it should be examined for a possible clinical role in the treatment of acute mesenteric ischemia in humans.