title: Attenuation of Oxidative Stress by Ischemic Preconditioning in an Experimental Model of Intraabdominal Hypertension.
abstract: OBJECTIVE
  Increased intra-abdominal pressure, as used in laparoscopic surgery or seen in intraabdominal hypertension (IAH), is associated with tissue ischemia and oxidative stress. Ischemic preconditioning (IP) is a method successfully used in liver and transplant surgery, in order to attenuate the detrimental effects of ischemia and reperfusion. In this experimental study, we tested the ability of IP to modify oxidative stress induced by extremely high intraabdominal pressures.
  
  
  METHODS
  Twenty-five female pigs were studied and divided in three groups: a control group, a pneumoperitoneum group (with pressure of 30 mmHg), and an ischemic preconditioning group (initially subjected to preconditioning with pressure of 25 mmHg for 15 min and desufflation for 15 min and then to pneumoperitoneum as in pneumoperitoneum group). Blood samples were obtained at identical time intervals in the three groups. Total oxidative capacity, total antioxidative capacity and total nitric oxide (NO), nitrite and nitrate concentrations were measured and compared between groups.
  
  
  RESULTS
  IP increased total antioxidative capacity (p = .045) and protective mediators like nitrite (p = .022). It was also associated with a trend toward lower levels of total oxidative capacity at the end of the abdominal desufflation period but statistical significance was not met.
  
  
  CONCLUSIONS
  IP attenuated oxidative stress induced by IAH, mainly by increasing antioxidative capacity and the levels of protective mediators. The fact that IP was effective, even when used at extremely high levels of intraabdominal pressure, reinforces the interest on this method but further studies are needed to clarify its mechanism of action and potential clinical applications.
authors: a Department of Surgery, The Whittington Hospital, NHS Trust , London , UK.
authors: Aikaterini
authors: A
authors: Leventi
authors: b First Department of Anaesthesiology, Aretaieion University Hospital , Athens , Greece.
authors: Eriphylli
authors: E
authors: Argyra
authors: b First Department of Anaesthesiology, Aretaieion University Hospital , Athens , Greece.
authors: Alexandra
authors: A
authors: Avraamidou
authors: c Second Department of Surgery, Aretaieion University Hospital , Athens , Greece.
authors: Athanasios
authors: A
authors: Marinis
authors: c Second Department of Surgery, Aretaieion University Hospital , Athens , Greece.
authors: Spyridon
authors: S
authors: Asonitis
authors: d Laboratory of Experimental Surgery and Surgical Research "NS Christeas" (LESSR), Medical School of Athens, University of Athens , Athens , Greece.
authors: Despoina
authors: D
authors: Perrea
authors: c Second Department of Surgery, Aretaieion University Hospital , Athens , Greece.
authors: Dionysios
authors: D
authors: Voros
authors: Kassiani
authors: K
authors: Theodoraki
mesh_terms: D000818:Animals; D000975:Antioxidants / Q000378:metabolism*; D004195:Disease Models, Animal; D005260:Female; D059325:Intra-Abdominal Hypertension / Q000378:metabolism*; D019194:Ischemic Preconditioning; D017672:Nitrogen Compounds / Q000378:metabolism; D018384:Oxidative Stress; D011028:Pneumoperitoneum, Artificial; D011897:Random Allocation; D013552:Swine
chemical_list: D000975:Antioxidants; D017672:Nitrogen Compounds
keywords: Abdominal compartment syndrome; intraabdominal hypertension; ischemia–reperfusion injury; ischemic preconditioning; oxidative stress; swine