Can Chronic Intra-Abdominal Hypertension Cause Oxidative Stress to the Abdominal Wall Muscles? An Experimental Study

Kotidis, Efstathios; Papavramidis, Theodosis S.; Ioannidis, Konstantinos; Koliakos, George; Lazou, Thomai; Cheva, Angeliki; Michalopoulos, Nikolaos; Papavramidis, Spiros

doi:10.1016/j.jss.2011.07.020

Cited by 7 publications

(7 citation statements)

References 42 publications

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“…Oxidative stress has been proposed as a common underlying mechanism for many factors that induce intestinal barrier dysfunction. In the development of IAH, oxidative stress is also important and may precede permeability enhancement [5] – [7] . As shown in Table 3 , three groups have published related studies.…”

Section: Discussionmentioning

confidence: 99%

“…Among the organ systems frequently affected by IAH, the intestine is the most susceptible. Ischemic injury and subsequent reperfusion-induced oxidative damage are involved in the development of IAH [5] – [7] .Intestinal ischemia triggers the enhancement of intestinal permeability, bacterial translocation, and the subsequent systematic inflammatory response. These, in turn, cause capillary leakage that leads to bowel edema, thus further worsening the IAH and leading to a morbidity-ischemia cycle [8] – [11] .…”

Section: Introductionmentioning

confidence: 99%

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Effect of Acute, Slightly Increased Intra-Abdominal Pressure on Intestinal Permeability and Oxidative Stress in a Rat Model

et al. 2014

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IntroductionIntra-abdominal hypertension (IAH) is known as a common, serious complication in critically ill patients. Bacterial translocation and permeability changes are considered the pathophysiological bases for IAH-induced enterogenic endotoxemia and subsequent multiorgan failure. Nevertheless, the effects of slightly elevated intra-abdominal pressures (IAPs) on the intestinal mucosa and the associated mechanisms remain unclear.MethodsTo investigate the acute effects of different nitrogen pneumoperitoneum grades on colonic mucosa, male Sprague-Dawley rats were assigned to six groups with different IAPs (0 [control], 4, 8, 12, 16, and 20 mmHg, n = 6/group). During 90 min of exposure, we dynamically monitored the heart rate and noninvasive hemodynamic parameters. After gradual decompression, arterial blood gas analyses were conducted. Thereafter, structural injuries to the colonic mucosa were identified using light microscopy. Colon permeability was determined using the expression of tight junction proteins, combined with fluorescein isothiocyanate dextran (FD-4) absorption. The pro-oxidant-antioxidant balance was determined based on the levels of malondialdehyde (MDA) and antioxidant enzymes.ResultsIAH significantly affected the histological scores of the colonic mucosa, tight junction protein expression, mucosal permeability, and pro-oxidant-antioxidant balance. Interestingly, elevations of IAP that were lower than the threshold for IAH also showed a similar, undesirable effect. In the 8 mmHg group, mild hyponatremia, hypocalcemia, and hypoxemia occurred, accompanied by reduced blood and abdominal perfusion pressures. Mild microscopic inflammatory infiltration and increased MDA levels were also detected. Moreover, an 8-mm Hg IAP markedly inhibited the expression of tight junction proteins, although no significant differences in FD-4 permeability were observed between the 0- and 8-mmHg groups.ConclusionsAcute exposure to slightly elevated IAP may result in adverse effects on intestinal permeability and the pro-oxidant-antioxidant balance. Therefore, in patients with critical illnesses, IAP should be dynamically monitored and corrected, as soon as possible, to prevent intestinal mucosal injury and subsequent gut-derived sepsis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of Acute, Slightly Increased Intra-Abdominal Pressure on Intestinal Permeability and Oxidative Stress in a Rat Model

et al. 2014

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“…To the best of our knowledge this is the first trial investigating the correlation between polypropylene meshes for inguinal hernia repair and oxidative stress, considering the interest for oxidative stress [38,39] and antioxidative systems [40,41] in current research. Taking into account the supposed role of oxidative stress on the evolution of local complications, we hope that our study will stimulate a new research field on the evolution of prosthetic materials in abdominal wall surgery, maybe stimulating industries to produce not only “less inflammatory” but also “less oxidative” meshes.…”

Section: Discussionmentioning

confidence: 99%

Immunological reaction and oxidative stress after light or heavy polypropylene mesh implantation in inguinal hernioplasty

et al. 2016

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The relationship between mesh weight and host tissue reaction has, so far, not been fully investigated. Lightweight meshes (LWM) are thought to give less inflammatory response compared with heavyweight meshes (HWM). The present study is a randomized, controlled, double-blind clinical trial performed in 61 patients who underwent an elective inguinal hernioplasty. The primary outcome of the study was to investigate the relationship between total amount of prosthetic material (polypropylene), immunological reaction, and oxidative stress. The study was double-blinded. Sixty-one patients were recruited for the study and randomly assigned to 2 groups (groups A and B). Levels of inflammation markers (interleukin-6 [IL-6] and tumor necrosis factor-α [TNF-α]) and oxidative stress markers (reduced glutathione [GSH] and lipid hydroperoxides [LOOH]) were determined preoperatively and after undergoing inguinal hernioplasty (after 6, 72, and 288 hours), respectively, with LWM and HWM. There was no significant difference in IL-6 levels between HWM and LWM (P = 0.3, 0.7, 0.8 after 6, 72, and 288 hours, respectively). A statistically significant difference was found after 72 hours for TNF-α (P = 0.01), for GSH after 6 hours (P < 0.01), and after 6 and 72 hours for LOOH (P = 0.05, 0.01, respectively). Oxidative stress occurred at earlier time points and was pore accentuated HWM versus LWM and prodromal to TNF-α increase.Also, in randomized clinical trial, the use of LWM gives advantages in terms of less inflammatory response when compared with HWM. Moreover, there is a significant higher oxidative stress after implantation of HWM. The intensity of oxidative stress seems to be strongly related to the amount of implanted polypropylene. (Trial registration number: NCT01090284).

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“…According to the literature, intraabdominal pressure > 12 mm Hg is considered to be abdominal hypertension (10). Again it has been shown that increased intraabdominal pressure as it is seen in laparoscopy is associated with the decrease in intestinal perfusion and even ischemia (11)(12)(13)(14)(15)(16)(17). Increased intraabdominal pressure was also found to decrease mesenteric blood supply (18).…”

Section: Discussionmentioning

confidence: 99%

Comparison Effect of Direct Trocar and Veress Needle Entry Techniques on Gut Functions after Laparoscopic Procedures: Randomized Clinical Trial

Şenol

Polat

Özkaya

et al. 2016

Gynecol Obstet Reprod Med

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OBJECTIVE: The aim of this study was to compare the effect of two different laparoscopic entry methods on postoperative gastrointestinal functions. STUDY DESIGN: A total of 108 women who underwent gynecological operation via laparoscopic approach with different indications were randomly assigned to 2 groups: In Group 1 pneumoperiteneum was achieved by direct trocar entry (n=72), while in group 2, Veress needle was used. RESULTS: Correlation analyses showed a significant association between the technique for abdominal entry and postoperative hemoglobin and hematocrit concentrations, time to maximal intraabdominal pressure and the body mass index. Comparison of groups with different laparoscopic entry techniques showed a significant difference between groups in terms of postoperative hemoglobin and hematocrit concentrations, time to obtain maximal intraabdominal pressure and time to first flatulence (p < 0.05, Table 2). No intra or postoperative complications was observed. CONCLUSION: Direct or Veress needle entry methods were both safe to create pneumoperitoneum with similar postoperative gastrointestinal functions except for earlier first flatulence in Veress needle group while direct trocar entry was found to be associated with favorable postoperative blood count and shorter duration to obtain enough intraperitoneal pressure.

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Can Chronic Intra-Abdominal Hypertension Cause Oxidative Stress to the Abdominal Wall Muscles? An Experimental Study

Cited by 7 publications

References 42 publications

Effect of Acute, Slightly Increased Intra-Abdominal Pressure on Intestinal Permeability and Oxidative Stress in a Rat Model

Effect of Acute, Slightly Increased Intra-Abdominal Pressure on Intestinal Permeability and Oxidative Stress in a Rat Model

Immunological reaction and oxidative stress after light or heavy polypropylene mesh implantation in inguinal hernioplasty

Comparison Effect of Direct Trocar and Veress Needle Entry Techniques on Gut Functions after Laparoscopic Procedures: Randomized Clinical Trial

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