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01-08-2007 | Experimental

Microdialysis of the rectus abdominis muscle for early detection of impending abdominal compartment syndrome

Authors: Christoph Meier, Claudio Contaldo, Rene Schramm, Joerg H. Holstein, Juerg Hamacher, Michaela Amon, Guido A. Wanner, Otmar Trentz, Michael D. Menger

Published in: Intensive Care Medicine | Issue 8/2007

Abstract

Objective

To investigate whether microdialysis is capable of assessing metabolic derangements during intra-abdominal hypertension (IAH), and whether monitoring of the rectus abdominis muscle (RAM) by microdialysis represents a reliable approach in the early detection of organ dysfunctions in abdominal compartment syndrome (ACS).

Design

Prospective, randomized, controlled animal study.

Setting

University animal research facility.

Subjects

Fifteen isoflurane-anesthetized and mechanically ventilated Sprague–Dawley rats.

Interventions

IAH of 20 mmHg was induced for 3 h and followed by decompression and reperfusion for another 3-h period (n = 10). Five sham-operated animals served as controls. Microdialysis was performed in the anterior gastric wall, liver, kidney, and RAM. The anterior cervical muscles served as distant reference. Glucose, lactate, pyruvate, and glycerol was analyzed throughout the 6-h experiment.

Measurements and main results

Prolonged IAH induced significant cardiopulmonary dysfunction and persistent abdominal organ injury. Microdialysis revealed a significant increase of lactate/pyruvate and glycerol in kidney, intestine and liver, indicating ischemia, energy failure, and cell membrane damage. In addition, at 3 h IAH glucose was significantly decreased in all organs studied. The distant reference did not show any alteration of lactate/pyruvate, glycerol, and glucose over the entire 6-h observation period. In contrast to the other organs, microdialysis of the RAM showed an early and more pronounced increase of lactate, lactate/pyruvate and glycerol already at 1 h IAH. It is noteworthy that lactate, glycerol, and glucose did not completely recover upon decompression of IAH.

Conclusions

Our data suggest that continuous microdialysis in the RAM may represent a promising tool for early detecting IAH-induced metabolic derangements.

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Title: Microdialysis of the rectus abdominis muscle for early detection of impending abdominal compartment syndrome
Authors: Christoph Meier
Claudio Contaldo
Rene Schramm
Joerg H. Holstein
Juerg Hamacher
Michaela Amon
Guido A. Wanner
Otmar Trentz
Michael D. Menger
Publication date: 01-08-2007
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 8/2007
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-007-0725-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Microdialysis of the rectus abdominis muscle for early detection of impending abdominal compartment syndrome

Abstract

Objective

Design

Setting

Subjects

Interventions

Measurements and main results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Design

Setting

Subjects

Interventions

Measurements and main results

Conclusions

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