Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2011, vol. 20, nr 5, September-October, p. 613–621

Publication type: original article

Language: English

Dopamine – a Preventive Agent for Mesenteric Ischemia and Reperfusion Injury in Abdominal Compartment Syndrome

Dopamina – czynnik ochronny przed niedokrwieniem krezki i uszkodzeniem reperfuzyjnym w zespole ciasnoty śródbrzusznej

Ayten Saracoglu1,, Kemal T. Saracoglu1,, Mustafa Deniz2,, Feriha Ercan3,, Yunus Yavuz4,, Yılmaz Gogus1,

1 Department of Anesthesiology and Reanimation, Marmara University School of Medicine, Istanbul, Turkey

2 Department of Physiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey

3 Department of Histology and Embriology, Marmara University School of Medicine, Istanbul, Turkey

4 Department of General Surgery, Marmara University School of Medicine, Istanbul, Turkey

Abstract

Objectives. Acutely increased intra-abdominal pressure (IAP) may lead to abdominal compartment syndrome (ACS) and multiple organ failure. In a prospective randomized way, the effect of dopamine infusion (3 μg/kg/ min) on mesenteric perfusion, cytokine levels and intestinal histopathological changes were studied in the presence of ACS.
Material and Methods. The study involved 28 male Sprague Dawley rats randomly assigned to four groups (n = 7). The external jugular vein was cannulated for infusions. In group 1, before increasing IAP, a 60-minute infusion of dopamine was performed; following this, IAP was raised and the dopamine infusion was continued for another 60 minutes. In group 2 an IAP of 20 mm Hg was maintained for 60 minutes by air insufflation. In group 3, a dopamine infusion was performed simultaneously with an IAP of 20 mm Hg for 60 minutes. Group 4 was the control. Following this phase, midline laparatomy and superior mesenteric artery (SMA) dissection was carried out in all groups and SMA perfusion was measured continuously for 30 minutes with a Doppler probe. Myeloperoxidase (MPO) activity, lipid peroxidation and glutathione (GSH) levels were measured in tissue samples and histopathological scoring was carried out.
Results. The results demonstrated that SMA blood flow was increased in Group 1 and Group 3 (100.77 ± 2.94 and 93.82 ± 4.91 mm Hg, respectively) but decreased significantly in Group 2 (74.23 ± 3.01 mm Hg; p < 0.01). Intestinal tissue malondialdehyde (MDA) levels (24.03 ± 2.75 nmol/g) and MPO activity (260.5 ± 11 u/g) were elevated in Group 2; histological scores were elevated in all groups (p < 0.05); and GSH levels were reduced in Group 2 (0.58 ± 0.24 μmol/g; p < 0.01).
Conclusion. The results indicated that high IAP causes oxidative organ damage and that dopamine may lessen reperfusion-induced oxidative damage by reducing splanchnic perfusion and controlling the reperfusion of the intra-abdominal organs.

Streszczenie

Cel pracy. Bardzo podwyższone ciśnienie śródbrzuszne (IAP) może prowadzić do zespołu ciasnoty śródbrzusznej (ACS) i niewydolności wielonarządowej. W prospektywnym randomizowanym badaniu oceniono wpływ wlewu dopaminy (3 μg/kg/min) na perfuzję krezki, stężenie cytokin i histopatologiczne uszkodzenia jelit w obecności ACS.
Materiał i metody. Do badań włączono 28 samców szczurów Sprague Dawley, które przydzielono losowo do czterech grup (n = 7). Przez zewnętrzną żyłę szyjną wprowadzono kaniulę do infuzji. W grupie 1 przed zwiększeniem IAP przeprowadzono 60-minutową infuzję dopaminy, potem zwiększono IAP i kontynuowano wlew dopaminy przez kolejne 60 min. W grupie 2 IAP utrzymywano 20 mm Hg IAP przez 60 min za pomocą wdmuchiwania aspowietrza. W grupie 3 wlew dopaminy był prowadzony jednocześnie z 20 mm Hg IAP przez 60 min. Grupa 4 była kontrolna. Po tej fazie wykonano laparatomię w linii środkowej i wycięcie tętnicy krezkowej górnej (SMA) we wszystkich grupach. Za pomocą sondy Dopplera zmierzono perfuzję SMA w sposób ciągły przez 30 min. Oceniono aktywność mieloperoksydazy (MPO), peroksydację lipidów oraz stężenie glutationu (GSH) w próbkach tkanek i nadano histopatologiczną punktację.
Wyniki. Badanie wykazało, że przepływ krwi przez SMA był zwiększony w grupie 1 i grupie 3 (100,77 ± 2,94 i 93,82 ± 4,91 mm Hg), ale zmniejszył się znacząco w grupie 2 (74,23 ± 3,01 mm Hg, p < 0,01). Stężenie malondialdehydu (MDA) (24,03 ± 2,75 nmol/g) i aktywność MPO (260,5 ± 11 U/g) były zwiększone w tkankach jelit w grupie 2; histologiczna punktacja była większa w wszystkich grupach (p < 0,05), a stężenie GSH zmniejszyło się w grupie 2 (0,58 ± 0,24 mmol/g, p < 0,01).
Wnioski. Badania wykazały, że duże IAP powoduje oksydacyjne uszkodzenie narządów i że dopamina może zmniejszyć uszkodzenie oksydacyjne wywołane przez reperfuzję, ograniczając perfuzję trzewną i reperfuzję narządów jamy brzusznej.

Key words

abdominal compartment syndrome, ischemia/reperfusion, superior mesenteric artery, blood flow, dopamine

Słowa kluczowe

zespół ciasnoty śródbrzusznej, niedokrwienie/reperfuzja, tętnica krezkowa górna, przepływ krwi, dopamina

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