Mehmet Bugra BOZAN, Necip İLHAN, Erhan AYGEN, Ali AKSU, Nizamettin KUTLUER, Ayşe Azak BOZAN, Nurullah BULBULLER, Cemalettin CAMCI, Ibrahim Hanfi OZERCAN, Refik AYTEN

The diagnostic efficacy of some ischemic markers (urotensin II and urotensin II related peptide) in early diagnosis of intestinal ischemia in experimentally increased intraabdominal pressure in rats

Aim: The purpose of this experimental study is evaluating the relation between plasma urotensin-II (U-II) and urotensin-II relatedpeptide (URP) levels with intestinal ischemia caused by elevated intraabdominal pressure.Material-Methods: Wistar albino rats weighing 200–250 grams used.Group-1: Laparatomized group without abdominal pressure elevation in sixty minutes under general anesthesia.Group-2: Ten mmHg elevated intraabdominal pressure group in sixty minutes under general anesthesia.Group-3: Fifteen mmHg elevated intraabdominal pressure group in sixty minutes under general anesthesia.Group-4: Twenty mmHg elevated intraabdominal pressure group in sixty minutes under general anesthesia.After sacrifing, in general anesthesia blood and tissue samples were collected. Hematoxilen and eosyn stained tissue samples wereexamined under light microscope.Results: Plasma U-II levels changes insignificant in group 2 and 3 but in group-4 was changed significantly compared with thecontrol group(respectevely p=0,609; p=0.848; p=0.04). Plasma URP levels changed significantly in all groups compared with thecontrol group (p-values were p=0.018; p=0.018 and p=0.04 respectively).Conclusion: U-II levels could not be a useful parameter for the early diagnosis of the intestinal ischemic damage caused byintraabdominal pressure(IAP), because it is found in all vascular structures. On the other hand, plasma URP levels would be used forthe early diagnosis of the intestinal ischemia. Because of the limitations of our study, we believe that our results should be confirmedwith clinical studies.

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1. Dayal N, Dominique E. Abdominal Compartment Syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing; Jan, 2019. Updated; Nov 15, 2018.
2. Sosa G, Gandham N, Landeras V, et al. Abdominal compartment syndrome. Dis Mon 2019;65:5-19.
3. Diebel LN, Wilson RF, Dulchavsky SA, et al. Effect of increased intraabdominal pressure on hepatic arterial, portal venous, and hepatic microcirculatory blood flow. J Trauma 1992;33:279-82.
4. Ichikawa T, McMaster D, Lederis K, et al. Isolation and amino acid sequence of urotensin I, a vasoactive and ACTHreleasing neuropeptide, from the carp (Cyprinus carpio) urophysis. Peptides 1982;3:859-67.
5. Cadirci E, Ugan RA, Dincer B, et al.Urotensin.receptor as a new target for CLP induced septic lung injury in mice. Naunyn Schmiedebergs Arch Pharmacol 2019;392:135-45.
6. Vaudry H, Leprince J, Chatenet D,.et al. International Union of Basic and Clinical Pharmacology. XCII. Urotensin II, Urotensin II–Related Peptide, and Their Receptor: From Structure to Function. Pharmacol Rev 2015;67:214-58.
7. Totsune K, Takahashi K, Arihara Z, et al. Role of urotensin II in patients on dialysis. Lancet 2001;358: 810-1.
8. Grieco P, Gomez-Monterrey I. Natural and synthetic peptides in the cardiovascular diseases: An update on diagnostic and therapeutic potentials. Arch Biochem Biophys 2019;662:15- 32.
9. Yagmur Y, Aldemir M, Ozturk H, Guloglu C, Geyik MF, Orucu M. Intestinal ischemia and bacterial translocation in the abdominal compartment syndrome. T Klin J Sci 2000;20:197-202.
10. Chiu CJ, McArdle AH, Brown R, et al. Intestinal mucosal lesion in low flow states. I. A morphological, hemodynamic, and metabolic reapprasial. Arch Surg 1970;101:478-3.
11. Montgomery A, Hartmann M, Jönsson K, et al. Intramucosal PH measurements with tonometers for detecting gastrointestinal ischaemia in porcine hemorrhagic shock. Circ Shock 1989;29:319-27.
12. Richards WO, Scovill W, Shin B, et al Acute renal failure associated with increased intraabdominal pressure. Ann Surg 1983;197:183-7.
13. Prasad GR, Subba Rao JV, Aziz A, et al. The role of routine measurement of intra-abdominal pressure in preventing abdominal compartment syndrome. J Indian Assoc Pediatr Surg 2017;22:134-8.
14. Roberts DJ, Ball CG, Kirkpatrick AW. Increased pressure within.the abdominal compartment: intra-abdominal hypertension and the abdominal compartment syndrome. Curr Opin Crit Care 2016;22:174-85.
15. Nguyen J, Noory M, Capano-Wehrle L, et al. Expeditious Diagnosis and Laparotomy for Patients with Acute Abdominal Compartment Syndrome May Improve Survival. Am Surg 2018;84:1836-40.
16. Richman A, Burlew CC. Lessons from Trauma Care: Abdominal Compartment Syndrome and Damage Control Laparatomy in the Patients with Gastrointestinal Disease. J Gastrointest Surg 2019;23:417-24.
17. Regli A, Pelosi P, Malbrain MLNG. Ventilation in patients with intra-abdominal hypertension: what every critical care physician needs to know. Ann Intensive Care 2019 Apr 25;9:52.
18. Roberts DJ, Ball CG, Kirkpatrick AW. Increased pressure within the abdominal compartment: intra-abdominal hypertension and the abdominal compartment syndrome. Curr Opin Crit Care 2016;22:174-85.
19. Ames RS, Sarau HM, Chambers JK, et al. Human urotensin- II is a potent vasoconstrictor and agonist for the orphan receptor GPR14. Nature 1999; 282-6.