Ali Kemal KAYAPINAR, Mehmet YILDIRIM, Nazif ERKAN, Baysal KARACA, Ayten COŞKUNER

AKUT ABDOMİNAL HİPERTANSİYONUN DEKOMPRESYONUNDA OKTREOTİD’ İN ETKİSİ: DENEYSEL ÇALIŞMA

Akut karın içi basınç KİB artışı abdominal kompartman sendromuna AKS yol açabilir. İskemi/Re-perfüzyon İ/R hasarı AKS patogenezinde önemli bir role sahiptir. AKS’da tedavinin temel amacı re-perfüzyon hasarına rağmen KİB’ın acilen düşürülmesidir. Bu çalışmanın amacı, akut abdominal hipertansiyonun dekompresyonunda oktreotid’in reperfüzyon hasarını ve bakteriyel translokasyonu azaltıp azaltmayacağını belirlemektir. Bu amaçla sıçanlara ketamin anestezisi altında, perkutan intraperitoneal kateter yerleştirilerek manometre sistemine bağlandı. Ratlar aşağıdaki gruplara ayrıldı. KİB 1 saat boyunca iskemi İ grubunda 20 mmHg düzeyinde tutuldu. İ/R grubunda 1 saatlik bu basıncı+ dekompresyon +1 saat re-perfüzyon İ/R grubu+ 100 mikrogram/kg oktreotid+dekompresyon İ/R grubuna oktreotid uygulanması ile serum karaciğer enzimleri düzeylerindeki yükselme olmamış ve bakteriyel translokasyon daha az olmuştur. Sonuç olarak oktreotid AKS de I/R grubunda etkili bulunmuştur. Daha ileri çalışmaların oktreotidin KİB ve AKS da daha kesin etkilerini göstereceğine inanmaktayız

Anahtar Kelimeler:

Abdominal kompartman, oktreotid

AKUT ABDOMİNAL HİPERTANSİYONUN DEKOMPRESYONUNDA OKTREOTİD’ İN ETKİSİ: DENEYSEL ÇALIŞMA

Acut intra-abdominal hypertansion IAH may lead to abdominal compartment syndrome ACS . Ischaemia/reperfusion I/R injury plays an important role on ACS. The aim of management of ACS is to lower pressure despite reperfusion. The study was performed to investigate whether octretid improves the reperfusion injury and bacteriel translocation in rat model. We analysed liver blood enzymes,bacterial samples in vena porta and bacteria in the intestinal lymph nodes.Under ketamin anesthesia, a percutan catheter was inserted intraperitoneally. Catheter was connected to a manoneter. Gruops were divided as follows: İschaemia groups: IA pressure was kept at 20 mmHg for 1h. I/R group: 1 hour pressure +decompression+ 1 hour reperfusion. I/R +octreotid:1 hour pressure+ octreotid 100 microg/kg i.p.+ decompression. In results liver enzymes levels were not elevated and also bacteriel transformation was not found in the I/R +octreotid group. In conclusion, we found that octretid is an effective drug to prevent I/R injury at the ACS. We believe that the further investigations will show more definite effects of octretid at the IAH and ACS

Keywords:

abdominal compartment, octretid,

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