Microdialysis of the rectus abdominis muscle for early detection of impending abdominal compartment syndrome.
OBJECTIVE
To investigate whether microdialysis is capable of assessing metabolic derangements during intra-abdominal hypertension (IAH), and whether monitoring of the rectus abdominis muscle (RAM) by microdialysis represents a reliable approach in the early detection of organ dysfunctions in abdominal compartment syndrome (ACS).


METHODS
Prospective, randomized, controlled animal study.


METHODS
University animal research facility.


METHODS
Fifteen isoflurane-anesthetized and mechanically ventilated Sprague-Dawley rats.


METHODS
IAH of 20 mmHg was induced for 3 h and followed by decompression and reperfusion for another 3-h period (n = 10). Five sham-operated animals served as controls. Microdialysis was performed in the anterior gastric wall, liver, kidney, and RAM. The anterior cervical muscles served as distant reference. Glucose, lactate, pyruvate, and glycerol was analyzed throughout the 6-h experiment.


RESULTS
Prolonged IAH induced significant cardiopulmonary dysfunction and persistent abdominal organ injury. Microdialysis revealed a significant increase of lactate/pyruvate and glycerol in kidney, intestine and liver, indicating ischemia, energy failure, and cell membrane damage. In addition, at 3 h IAH glucose was significantly decreased in all organs studied. The distant reference did not show any alteration of lactate/pyruvate, glycerol, and glucose over the entire 6-h observation period. In contrast to the other organs, microdialysis of the RAM showed an early and more pronounced increase of lactate, lactate/pyruvate and glycerol already at 1 h IAH. It is noteworthy that lactate, glycerol, and glucose did not completely recover upon decompression of IAH.


CONCLUSIONS
Our data suggest that continuous microdialysis in the RAM may represent a promising tool for early detecting IAH-induced metabolic derangements.
Meier
Christoph
C
Institute for Clinical and Experimental Surgery, University of Saarland, Homburg/Saar, Germany. christoph.meier@usz.ch
Contaldo
Claudio
C
Schramm
Rene
R
Holstein
Joerg H
JH
Hamacher
Juerg
J
Amon
Michaela
M
Wanner
Guido A
GA
Trentz
Otmar
O
Menger
Michael D
MD
D000005:Abdomen / Q000503:physiopathology*; D000818:Animals; D001158:Arteries; D003161:Compartment Syndromes / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D004195:Disease Models, Animal; D042241:Early Diagnosis; D005858:Germany; D006973:Hypertension / Q000378:metabolism / Q000503:physiopathology; D042282:Microdissection; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D017568:Rectus Abdominis; D015427:Reperfusion Injury