Skip to main content
Top
Published in: Digestive Diseases and Sciences 12/2006

01-12-2006 | Original Paper

The Relationship Between Intestinal Hypoperfusion and Serum D-Lactate Levels During Experimental Intra-Abdominal Hypertension

Authors: Arife Polat Duzgun, Baris Gulgez, Anil Özmutlu, Didem Ertorul, Güler Bugdayci, Nurten Akyurek, Faruk Coskun

Published in: Digestive Diseases and Sciences | Issue 12/2006

Login to get access

Abstract

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) may result from several clinic situations and carries high morbidity and mortality risk, particularly in intensive care unit patients. The clinical spectrum changes from splanchnic hypoperfusion and intestinal ischemia to multiple organ failure. Previous studies demonstrated that serum D-lactate levels may be an early indicator in intestinal ischemia. This study aimed to investigate the relationship between intestinal ischemia and serum D-lactate levels during experimental IAH. Thirty-two male Wistar Albino rats weighing 250±50 g were divided into four groups. Three different intra-abdominal pressure (IAP) levels supplied by placement of an intraperitoneal Peritofix catheter and iso-osmotic polyethylene glycol infusion. Each of the IAP levels (15, 20, and 25 mm Hg groups) was checked with the monitor system and fixed for an hour. Control-group animals were not subjected to increased IAP. One hour later, 5-ml blood samples were taken for measurement of serum D-lactate levels and 2-cm intestinal tissue samples were taken 5 cm proximal to the ileocecal valve for histopathologic examination. Elevated serum D-lactate levels were recorded in animals with higher IAP levels.There was a positive correlation between serum D-lactate levels and IAP levels. Histological examinations of the intestinal tissue samples showed no significant pathologic changes in concordance with intestinal ischemia. Serum D-lactate levels may be an early indicator for increased IAP pressure before intestinal ischemic changes occur.
Footnotes
1
Citation of Fig. 1 here OK? If not, pls. cite in correct location. Thank you.
 
2
This sentence as meant? If not, pls. correct. Thank you.
 
Literature
1.
go back to reference Sanchez N, Tenofsky, et al. (2001) What is the abdominal pressure? Am Surg 67:243–248PubMed Sanchez N, Tenofsky, et al. (2001) What is the abdominal pressure? Am Surg 67:243–248PubMed
2.
go back to reference Hong JJ, Cohn JM, Perez, Dolich MO, Brown M, McKenney (2002) Prospective study of the incidence and outcome of intra-abdominal hypertension and the abdominal compartment syndrome. Br J Surg 89:591–596CrossRefPubMed Hong JJ, Cohn JM, Perez, Dolich MO, Brown M, McKenney (2002) Prospective study of the incidence and outcome of intra-abdominal hypertension and the abdominal compartment syndrome. Br J Surg 89:591–596CrossRefPubMed
3.
go back to reference McNellis J, Soffer S, Marini C, Ritter G (2002) Abdominal compartment syndrome in the surgical intensive care unit. Am Surg 68:18–23 McNellis J, Soffer S, Marini C, Ritter G (2002) Abdominal compartment syndrome in the surgical intensive care unit. Am Surg 68:18–23
4.
go back to reference Sieh KM, Kent, Chu M (2001) Intra-abdominal hypertension and abdominal compartment syndrome. Arch Surg 386:53–61CrossRef Sieh KM, Kent, Chu M (2001) Intra-abdominal hypertension and abdominal compartment syndrome. Arch Surg 386:53–61CrossRef
5.
go back to reference Ivatury R, Diebel L, Porter J, Simon R (1997) Intra-abdominal hypertension and the abdominal compartment syndrome. Surg Clin North Am 77:783–800CrossRefPubMed Ivatury R, Diebel L, Porter J, Simon R (1997) Intra-abdominal hypertension and the abdominal compartment syndrome. Surg Clin North Am 77:783–800CrossRefPubMed
6.
go back to reference Diebel L, Dulchavsky S, et al. (1997) Splanchnic ischemia and bacterial translocation in the abdominal compartment syndrome. J Trauma 43:852–856PubMed Diebel L, Dulchavsky S, et al. (1997) Splanchnic ischemia and bacterial translocation in the abdominal compartment syndrome. J Trauma 43:852–856PubMed
7.
go back to reference Kologlu M, Sayek I, Kologlu B, Demirali O (1999) Effect of persistently elevated intra-abdominal pressure on healing of colonic anastomoses. Am J Surg 178:293–297CrossRefPubMed Kologlu M, Sayek I, Kologlu B, Demirali O (1999) Effect of persistently elevated intra-abdominal pressure on healing of colonic anastomoses. Am J Surg 178:293–297CrossRefPubMed
8.
go back to reference Meldrum D, Moore F, Moore E, Francois R (1997) Prospective characterization and selective management of the abdominal compartment syndrome. Am J Surg 174:667–672CrossRefPubMed Meldrum D, Moore F, Moore E, Francois R (1997) Prospective characterization and selective management of the abdominal compartment syndrome. Am J Surg 174:667–672CrossRefPubMed
9.
go back to reference Szalay L, Umar F, Kham A, et al. (2003) Increased plasma D-lactate is associated with the severity of hemorrhagic/traumatic shock in rats. Shock 3:245–251CrossRef Szalay L, Umar F, Kham A, et al. (2003) Increased plasma D-lactate is associated with the severity of hemorrhagic/traumatic shock in rats. Shock 3:245–251CrossRef
10.
go back to reference Murray M, Barbose J, Cobb C (1993) Serum D-lactate levels as a predictor of acute intestinal ischemia in a rat model. J Surg Res 54:507–509CrossRefPubMed Murray M, Barbose J, Cobb C (1993) Serum D-lactate levels as a predictor of acute intestinal ischemia in a rat model. J Surg Res 54:507–509CrossRefPubMed
11.
go back to reference Murray M, Gonze M, Nowak L, Cobb C (1994) Serum D-lactate levels as an aid to diagnosing acute intestinal ischemia. Am J Surg 167:575–578CrossRefPubMed Murray M, Gonze M, Nowak L, Cobb C (1994) Serum D-lactate levels as an aid to diagnosing acute intestinal ischemia. Am J Surg 167:575–578CrossRefPubMed
12.
go back to reference Poeze M, Solberg B, Greve JW (2003) Gastric PgO2 and Pg-aCO2 gaps are related to D-lactate and not to L-lactate levels in patients with septic shock. Intensive Care Med 29:2081–2085CrossRefPubMed Poeze M, Solberg B, Greve JW (2003) Gastric PgO2 and Pg-aCO2 gaps are related to D-lactate and not to L-lactate levels in patients with septic shock. Intensive Care Med 29:2081–2085CrossRefPubMed
13.
go back to reference Marti R, Vanela E, et al. (1997) Determination of D-lactate by enzymatic methods in biological fluids; study of interferences. Clin Chem 43:1010–1015PubMed Marti R, Vanela E, et al. (1997) Determination of D-lactate by enzymatic methods in biological fluids; study of interferences. Clin Chem 43:1010–1015PubMed
14.
go back to reference Chiu CT, McArdle AH, Brown R, Scott H, Gurd F (1970) Intestinal mucosal lesion in low flow states. Arch Surg 101:478–483PubMed Chiu CT, McArdle AH, Brown R, Scott H, Gurd F (1970) Intestinal mucosal lesion in low flow states. Arch Surg 101:478–483PubMed
15.
go back to reference Malbrain M, Davide C, Pelosi P, Luciano G (2005) Incidence and prognosis of intra-abdominal hypertension in a mixed population of critically ill patients: a multiple-center epidemiological study. Crit Care Med 33:315–322CrossRefPubMed Malbrain M, Davide C, Pelosi P, Luciano G (2005) Incidence and prognosis of intra-abdominal hypertension in a mixed population of critically ill patients: a multiple-center epidemiological study. Crit Care Med 33:315–322CrossRefPubMed
16.
go back to reference Rezende-Neto J, Moore E, Vinicius M, et al. (2002) Systemic inflammatory responses secondary to abdominal compartment syndrome; stage for muliple organ failure. J Trauma 53:1121–1128PubMed Rezende-Neto J, Moore E, Vinicius M, et al. (2002) Systemic inflammatory responses secondary to abdominal compartment syndrome; stage for muliple organ failure. J Trauma 53:1121–1128PubMed
17.
go back to reference Malbrain MLNG (1999) Abdominal pressure in the critically ill:measurement and clinical relevance. Intens Care 25:1453–1458CrossRef Malbrain MLNG (1999) Abdominal pressure in the critically ill:measurement and clinical relevance. Intens Care 25:1453–1458CrossRef
18.
go back to reference Engum SA, Kogon B, Jensen E (2002) Gastric tonometry and direct intra-abdominal pressure monitoring in abdominal compartment syndrome. J Pediatr Surg 37:214–218CrossRefPubMed Engum SA, Kogon B, Jensen E (2002) Gastric tonometry and direct intra-abdominal pressure monitoring in abdominal compartment syndrome. J Pediatr Surg 37:214–218CrossRefPubMed
19.
go back to reference Moore AFK, Hargest R, Martin M, Delicata RJ (2004) Intraabdominal hypertension and the abdominal compartment syndrome. Br J Surg 91:1102–1110CrossRefPubMed Moore AFK, Hargest R, Martin M, Delicata RJ (2004) Intraabdominal hypertension and the abdominal compartment syndrome. Br J Surg 91:1102–1110CrossRefPubMed
20.
go back to reference Kirkpatrick A, Brenneman F, McLean R, Boulanger B (2000) Is clinical examination an accruate indicator of raised intra-abdominal pressure in critically injured patients? Can J Surg 43:207–211PubMed Kirkpatrick A, Brenneman F, McLean R, Boulanger B (2000) Is clinical examination an accruate indicator of raised intra-abdominal pressure in critically injured patients? Can J Surg 43:207–211PubMed
21.
go back to reference Robotham J, Wise R, Bromberger B (1985) Effects of changes in abdominal pressure on left ventricular performance and regional blood flow. Crit Care Med 13:803–809PubMedCrossRef Robotham J, Wise R, Bromberger B (1985) Effects of changes in abdominal pressure on left ventricular performance and regional blood flow. Crit Care Med 13:803–809PubMedCrossRef
22.
go back to reference Bloomfield G, Saggi B, Blocher C, Sugerman H (1999) Physiologic effects of externally applied continuous negative abdominal pressure for intra-abdominal hypertension. J Trauma 46:1009–1013PubMed Bloomfield G, Saggi B, Blocher C, Sugerman H (1999) Physiologic effects of externally applied continuous negative abdominal pressure for intra-abdominal hypertension. J Trauma 46:1009–1013PubMed
23.
go back to reference Oda J, Ivatury R, Blocher R, Malhotra A (2002) Amplified cytokine response and lung injury by sequential abdominal hemorrhagic shock and compartment syndrome in laboratory model of ischemia-reperfusion. J Trauma 52:625–632PubMed Oda J, Ivatury R, Blocher R, Malhotra A (2002) Amplified cytokine response and lung injury by sequential abdominal hemorrhagic shock and compartment syndrome in laboratory model of ischemia-reperfusion. J Trauma 52:625–632PubMed
24.
go back to reference Gudmundson FF, Gislason A, et al. (2001) Effects of prolonged increased intra-abdominal pressure on gastrointestinal blood flows in pigs. Surg Endosc 15:854–860CrossRef Gudmundson FF, Gislason A, et al. (2001) Effects of prolonged increased intra-abdominal pressure on gastrointestinal blood flows in pigs. Surg Endosc 15:854–860CrossRef
25.
go back to reference Schachtrupp A, Graf J, Tons C, Hoer J (2003) Intravasculer volume depletion in a hour porcine model of intra abdominal hypertension. J Trauma 55:734–740PubMed Schachtrupp A, Graf J, Tons C, Hoer J (2003) Intravasculer volume depletion in a hour porcine model of intra abdominal hypertension. J Trauma 55:734–740PubMed
26.
go back to reference Doty J, Oda J, Ivatury R (2002) The effects of hemodynamic shock and increased intra-abdominal pressure on bacterial translocation. J Trauma 52:13–17PubMedCrossRef Doty J, Oda J, Ivatury R (2002) The effects of hemodynamic shock and increased intra-abdominal pressure on bacterial translocation. J Trauma 52:13–17PubMedCrossRef
27.
go back to reference Hunter JD, Damani Z (2004) Intra-abdominal hypertension and the abdominal compartment syndrome. Anaesthesia 59:899–907CrossRefPubMed Hunter JD, Damani Z (2004) Intra-abdominal hypertension and the abdominal compartment syndrome. Anaesthesia 59:899–907CrossRefPubMed
28.
go back to reference Hsu YP, Chen RJ, Feng J (2004) Increases suscepility to oxidant injury in hepatocytes from rats with intra-abdominal hypertension. J Trauma 57:569–575PubMed Hsu YP, Chen RJ, Feng J (2004) Increases suscepility to oxidant injury in hepatocytes from rats with intra-abdominal hypertension. J Trauma 57:569–575PubMed
29.
go back to reference Gracias V, Braslow B, Johnson J (2002) Abdominal compartment syndrome in the open abdomen. Arch Surg 137:1300–1306 Gracias V, Braslow B, Johnson J (2002) Abdominal compartment syndrome in the open abdomen. Arch Surg 137:1300–1306
Metadata
Title
The Relationship Between Intestinal Hypoperfusion and Serum D-Lactate Levels During Experimental Intra-Abdominal Hypertension
Authors
Arife Polat Duzgun
Baris Gulgez
Anil Özmutlu
Didem Ertorul
Güler Bugdayci
Nurten Akyurek
Faruk Coskun
Publication date
01-12-2006
Published in
Digestive Diseases and Sciences / Issue 12/2006
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-006-9334-7

Other articles of this Issue 12/2006

Digestive Diseases and Sciences 12/2006 Go to the issue