open access

Vol 49, No 2 (2017)
Original and clinical articles
Published online: 2017-05-12
Submitted: 2017-03-13
Accepted: 2017-05-01
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Early impact of abdominal compartment syndrome on liver, kidney and lung damage in a rodent model

Ricardo Lima, Pedro L. Silva, Vera L. Capelozzi, Mariana G. Oliveira, Maria Cristina E. Santana, Fernanda F. Cruz, Paolo Pelosi, Alberto Schanaider, Manu L.N.G. Malbrain, Patricia R.M. Rocco
DOI: 10.5603/AIT.a2017.0021
·
Anaesthesiol Intensive Ther 2017;49(2):130-138.

open access

Vol 49, No 2 (2017)
Original and clinical articles
Published online: 2017-05-12
Submitted: 2017-03-13
Accepted: 2017-05-01

Abstract

BACKGROUND: Abdominal compartment syndrome (ACS) sometimes occurs in critically ill patients following damage control surgery. The purpose of the present study was to develop a model of ACS and to evaluate its pathologic impact on liver, kidney, and lung morphology.

METHODS: Twenty Wistar rats (mass 300–350 g) were randomly divided into four groups: 1) intra-abdominal hypertension (IAH): a laparotomy was performed and the abdomen packed with cotton until an intra-abdominal pressure (IAP) of 15 mm Hg was reached; 2) hypovolemia (HYPO): blood was withdrawn until a mean arterial pressure ~60 mm Hg was reached; 3) IAH + HYPO (to resemble clinical ACS); and 4) sham surgery. After 3 hours of protective mechanical ventilation, the animals were euthanized and the liver, kidney and lungs removed to examine the degree of tissue damage.

RESULTS: IAH resulted in the following: oedema and neutrophil infiltration in the kidney; necrosis, congestion, and microsteatosis in the liver; and alveolar collapse, haemorrhage, interstitial oedema, and neutrophil infiltration in the lungs. Furthermore, IAH was associated with greater cell apoptosis in the kidney, liver and lungs compared to sham surgery. HYPO led to oedema and neutrophil infiltration in the kidney. The combination of IAH and HYPO resulted in all the aforementioned changes in lung, kidney and liver tissue, as well as exacerbation of the inflammatory process in the kidney and liver and kidney cell necrosis and apoptosis.

CONCLUSIONS: Intra-abdominal hypertension by itself is associated with kidney, liver and lung damage; when combined with hypovolemia, it leads to further impairment and organ damage.

Abstract

BACKGROUND: Abdominal compartment syndrome (ACS) sometimes occurs in critically ill patients following damage control surgery. The purpose of the present study was to develop a model of ACS and to evaluate its pathologic impact on liver, kidney, and lung morphology.

METHODS: Twenty Wistar rats (mass 300–350 g) were randomly divided into four groups: 1) intra-abdominal hypertension (IAH): a laparotomy was performed and the abdomen packed with cotton until an intra-abdominal pressure (IAP) of 15 mm Hg was reached; 2) hypovolemia (HYPO): blood was withdrawn until a mean arterial pressure ~60 mm Hg was reached; 3) IAH + HYPO (to resemble clinical ACS); and 4) sham surgery. After 3 hours of protective mechanical ventilation, the animals were euthanized and the liver, kidney and lungs removed to examine the degree of tissue damage.

RESULTS: IAH resulted in the following: oedema and neutrophil infiltration in the kidney; necrosis, congestion, and microsteatosis in the liver; and alveolar collapse, haemorrhage, interstitial oedema, and neutrophil infiltration in the lungs. Furthermore, IAH was associated with greater cell apoptosis in the kidney, liver and lungs compared to sham surgery. HYPO led to oedema and neutrophil infiltration in the kidney. The combination of IAH and HYPO resulted in all the aforementioned changes in lung, kidney and liver tissue, as well as exacerbation of the inflammatory process in the kidney and liver and kidney cell necrosis and apoptosis.

CONCLUSIONS: Intra-abdominal hypertension by itself is associated with kidney, liver and lung damage; when combined with hypovolemia, it leads to further impairment and organ damage.

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Keywords

hypovolemia; intra-abdominal hypertension; apoptosis; necrosis; rodents, rats

About this article
Title

Early impact of abdominal compartment syndrome on liver, kidney and lung damage in a rodent model

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 49, No 2 (2017)

Pages

130-138

Published online

2017-05-12

DOI

10.5603/AIT.a2017.0021

Bibliographic record

Anaesthesiol Intensive Ther 2017;49(2):130-138.

Keywords

hypovolemia
intra-abdominal hypertension
apoptosis
necrosis
rodents
rats

Authors

Ricardo Lima
Pedro L. Silva
Vera L. Capelozzi
Mariana G. Oliveira
Maria Cristina E. Santana
Fernanda F. Cruz
Paolo Pelosi
Alberto Schanaider
Manu L.N.G. Malbrain
Patricia R.M. Rocco

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