The Effects of Chronically Increased Intra-abdominal Pressure on the Rabbit Diaphragm

Papavramidis, Theodossis S.; Kotidis, Efstathios; Ioannidis, Konstantinos; Cheva, Angeliki; Lazou, Thomai; Koliakos, George; Karkavelas, George; Papavramidis, Spiros

doi:10.1007/s11695-012-0587-2

Cited by 10 publications

(7 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In humans, apart from more nutritional reserves, higher levels of pro-inflammatory 37 and anti-inflammatory cytokines, 38,39 and the higher cholesterol and lipid levels common in obese patients that bind endotoxin during critical illness and provide the precursors for adrenal steroid synthesis 40 have been related to the beneficial effects of a higher BMI. In addition, neutrophil dysfunction and attenuation of acute lung injury, 41 and diaphragmatic remodeling due to chronically increased mass 42 and chronically increased intra-abdominal pressure 43 are possibly related to a lower acute respiratory distress syndrome incidence in obese patients. 44 While our study demonstrates the absence of a clear association between BMI and the cytokine response, we acknowledge several limitations.…”

Section: Discussionmentioning

confidence: 99%

Body mass index is not associated with cytokine induction during experimental human endotoxemia

et al. 2013

View full text Add to dashboard Cite

A higher body mass index (BMI) appears to be associated with lower mortality in critically ill patients, possibly explained by an altered innate immune response. However, the precise relationship between BMI and the innate immune response in humans in vivo is unknown. We investigated the relationship between BMI and the systemic cytokine response during experimental human endotoxemia. Endotoxemia was induced in 112 healthy male volunteers by intravenous administration of 2 ng/kg Escherichia coli endotoxin. Plasma concentrations of TNF-α, IL-6, IL-10 and IL-1RA were serially determined. The relationship between BMI and the cytokine response, as well as body temperature, was investigated. The BMIs of the participants ranged from 18.3 to 33.6 kg/m(2), (median: 22.7 kg/m(2)). All participants showed a marked increase in plasma cytokine levels [median (interquartile range)] peak levels: TNF-α 509 (353-673) pg/ml; IL-6 757 (522-1098) pg/ml; IL-10 271 (159-401) pg/ml; IL-1RA 4882 (3927-6025) pg/ml; and an increase in body temperature [1.8(1.4-2.2)] during endotoxemia. No significant correlations were found between BMI and levels of any of the cytokines or body temperature. No relationship between BMI and the cytokine response was found in healthy volunteers subjected to experimental endotoxemia. These data question the relationship between BMI and cytokine responses in critical illness.

show abstract

Section: Discussionmentioning

confidence: 99%

Body mass index is not associated with cytokine induction during experimental human endotoxemia

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Also animal studies in rabbits show that chronically increased intra-abdominal pressure induce several histological and cellular changes in composition of greater abdominal muscles, especially the rectus abdominis and diaphragm muscle (Kotidis et al 2011 , 2012 ; Papavramidis et al 2011 , 2012 ). Changes in muscle fiber composition of the muscles were observed, an increased ratio of type II muscle fibers that are mainly anaerobically active (Kotidis et al 2011 , 2012 ; Papavramidis et al 2011 , 2012 ).…”

Section: Discussionmentioning

confidence: 99%

Effects of bariatric surgery on inspiratory muscle strength

et al. 2015

View full text Add to dashboard Cite

BackgroundThe respiratory function is affected by obesity due to an increased deposition of fat on the chest wall. The objective of this study was to investigate the strength of the inspiratory respiratory muscles of obese individuals and the possible influence of bariatric surgery on it by measuring the maximum inspiratory pressure (MIP).MethodsPatients referred to a bariatric centre between the 3rd of October 2011 and the 3rd of May 2012 were screened preoperatively by a multidisciplinary team. Their MIP was measured at screening and 3, 6 and 9 months postoperative. In case of a preoperative MIP lower than 70% of predicted pressure training was provided supervised by a physiotherapist.ResultsThe mean age of 124 included patients was 42.9 ± 11.0 years and mean BMI was 43.1 ± 5.2 kg/m2. The mean predicted MIP preoperatively was 127 ± 31 in cm H2O and the mean measured MIP was 102 ± 24 in cm H2O. Three patients (2.4%) received training. Three months after surgery the MIP was 76 ± 26 cm H2O, after 6 months 82 ± 28 cm H2O and after 9 months 86 ± 28 cm H2O. All postoperative measurements were significant lower than preoperatively (P < 0.05). The only influencing factor for the preoperative MIP was age (p = 0.014).ConclusionThe preoperative MIP values were significantly lower than the predicted MIP values, probably due to altered respiratory mechanics.

show abstract

“…Papavramidis et al . described that chronically increased intra-abdominal pressure (IAP) leads to both morphological and biochemical adaptations of the costal diaphragm [11]. Chronic IAP, such as obesity and ascites and so on, was reported to play an important role in the causes of a hernia at the weak point of the abdominal cavity [12,13].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic repair of secondary parahiatal hernia with incarceration of the stomach: a case report

Takemura

Mayumi²,

Ikebe³

et al. 2013

J Med Case Reports

View full text Add to dashboard Cite

IntroductionParahiatal hernia is an extremely rare subtype of hiatal hernia, which in turn is a type of diaphragmatic hernia in adults, and only a few cases have been reported to date. We report the case of a patient who suffered from gastric incarceration through an anatomically separate diaphragmatic defect, immediately lateral to a structurally normal esophageal hiatus, that developed after treatment of a malignant mesothelioma.Case presentationA 70-year-old Japanese man, who had undergone treatment for a left malignant pleural mesothelioma a year ago at another hospital, was referred to our institution following a 4-day history of epigastric pain. Esophagogastroscopy demonstrated a normal esophagogastric junction, with remarkable stenosis and active gastric ulcer of the gastric body. Histopathological examination of the gastric biopsy specimen confirmed a gastric ulcer. Furthermore, computed tomography revealed a large fluid-filled structure in the retrocardiac space. On the basis of preoperative data, we decided to attempt laparoscopic repair for the gastric volvulus. During surgery, gastric and omental herniation was observed within a peritoneal lined defect immediately lateral to the esophageal hiatus. Dissection near the esophageal hiatus revealed a discrete extrahiatal defect 3cm in diameter immediately adjacent to the left crus of the diaphragm. The parahiatal defect was closed using interrupted nonabsorbable heavy suture. The patient’s postoperative course was uneventful, and anastomotic leakage was not observed at postoperative barium swallowing.ConclusionsAlthough preoperative diagnosis of parahiatal hernia is difficult, a laparoscopic approach can be a useful therapeutic procedure not only for paraesophageal hernia but also for parahiatal hernia.

show abstract

The Effects of Chronically Increased Intra-abdominal Pressure on the Rabbit Diaphragm

Abstract: Chronically increased IAP induces alterations to the rabbit diaphragm. Adaptation, equivalent to strenuous contraction, transforms the diaphragm to be functionally more efficient toward workload but makes it vulnerable against oxidative stress.

Cited by 10 publications

References 39 publications

Body mass index is not associated with cytokine induction during experimental human endotoxemia

Body mass index is not associated with cytokine induction during experimental human endotoxemia

Effects of bariatric surgery on inspiratory muscle strength

Laparoscopic repair of secondary parahiatal hernia with incarceration of the stomach: a case report

Contact Info

Product

Resources

About