The diagnostic efficacy of some ischemic markers in early diagnosis of intestinal ischemia in experimentally increased intraabdominal pressure in rats

Abdominal compartment syndrome is caused as result of elevated intraabdominal pressure and is charecterized with multiple organ disfunction syndrome. Generally intraabdominal pressure above 25 mmHg is considered to be marked high levels. Abdominal compartment syndrome can cause ischemia, necrosis and septik problems ins gastrointestinal system with diminsihing mesenteric vascular flow. Serum prealbumin, D-dimer, creatinin cinase, D-laktat and plasma L-laktat, plasminogen, urotensin-II (U-II), urotensin-II related peptide (URP) levels were used to evaluate intestinal ischemia, serum AST, ALT, BUN and creatinin levels were used to evaluate hepatic and renal ischemic injury.In this study wistar albino rats weighing 200 ? 250 grams were used. Each groups are randomly seperated in four groups with seven members.Group 1: Laparatomized group without abdominal pressure elevation in sixty minutes general anesthesia.Group 2: Ten mmHg elevated intraabdominal pressure group in sixty minutes general anesthesia.Group 3: Fifteen mmHg elevated intraabdominal pressure group in sixty minutes general anesthesia.Group 4: Twenty mmHg elevated intraabdominal pressure group in sixty minutes general anesthesia.Rats were sacrified in general anestezia after surgical procedure, than blood and tissue samples were collected. Hematoxilen and eosyn stained tissue samples were examined under light microscope. Serum AST and ALT levels increased with the liver ischemic injury (p<0.05 for each parameters). Increase in BUN levels corolated with renal ischemic injury was statisticly significant (p < 0.05), but creatinin levels were increased statistically not significant with renal injury except 20 mmHg group (p values for each groups respectively p = 0,317, p = 0,317, p = 0,173). D-dimer level didn?t increase with the intestinal ischemia levels (p values for each groups respectively p = 0,317, p = 0,317, p = 0,173). Serum D-laktat, CPK levels increased with intestinal ischemia levels ( p < 0.05 for each parameters ). Plasma L-laktat levels decreased with intestinal ischemia levels (p<0.05). Plasma plasminogen levels didn?t change with the intestinal ischemia levels (p values for each groups respectively p=0.949, p=0.406, p=0.655). Increasing in plasma U-II levels in group 2 and 3 were not istatistically significant, decreasing plasma U-II levels in group 4 was istatistically significant (p values for group 2 ve 3 respectevely p=0,609 ve p=0.848, p values for group 4 p=0.04). Plasma URP levels increased istatistically significant in group 2 ve 3, decreased istatsitically significant in group 4 (her grup için p<0.05).In conclusion increasing plasma U-II levels can be helpful for the early diagnosis of the intestinal ischemia severity related with the elevated intraabdominal pressures but U-II levels can not be helpful. With ischemic injury severity diminishing in plasma U-II and URP levels can be helpful for evaluating intestinal ischemia process. These results must be supported by the clinical studies.