Peritoneal Potassium and pH Measurement in Early Diagnosis of Acute Mesenteric Ischemia in Rats

Abstract

Background:In contemporary practice, acute mesenteric ischemia (AMI) remains a serious cause of morbidity and mortality in abdominal emergencies.Objectives:We report the measurement of peritoneal fluid potassium and pH on a small series of rats that developed extensive AMI following the surgical ligation of superior mesenteric vessels and compare the results with control groups.Materials and Methods:A total of 32 rats were used in our study. They were divided into four groups with eight rats in each one and received following treatments: group I (G-I), 60-minute controls; group II (G-II), 120-minute controls; group III (G-III), 60-minute cases; and group IV (G-IV), 120-minute cases. In case groups, the small bowel mesenteric root was double-ligated and an arrow single-lumen central venous catheter was passed through the skin to the peritoneum. In control groups, the catheter was placed without any intervention. Postoperatively, peritoneal lavage was performed at 60 (G-I, G-III) and 120 minutes (G-II, G-IV).Results:The mean peritoneal potassium values were 1.3 ± 0.3, 1.97 ± 1.06, 2.14 ± 0.89, and 3.28 ± 0.66 mmol/L in G-I, G-II, G-III, and G-IV, respectively. There were significant differences between G-III and G-IV (P = 0.002), between G-I and G-III (P = 0.024), and between G-II and G-IV (P = 0.001). The mean values of peritoneal fluid pH were 7.1 ± 0.26, 6.82 ± 0.22, 6.66 ± 0.16, and 6.78 ± 0.04 in G-I, G-II, G-III, and G-IV, respectively, which indicated significant differences between G-I and G-III (P = 0.001) and between G-II and G-IV (P = 0.018). There was a significant correlation between peritoneal fluid potassium and intestine ischemic grade (F = 4.77, P = 0.048)ConclusionsOur findings show that for early detection of bowel ischemia, an evaluation of intraperitoneal potassium and pH was useful and with prolongation of ischemia, potassium changes were more significant.

The value of potassium, pH and D-dimer levels in early diagnosis of acute mesenteric ischemia: an experimental study on rats

“…These studies showed an early decrease in the pH of peritoneal lavage fluid and an increase in potassium. Consequently, experimental ischemia reports have shown that pH and potassium levels in peritoneal lavage fluid could be useful for early diagnosis when the blood pH has not yet increased [ 11 ].…”

“…New and facile diagnostic tools such as serum and peritoneal indicators can assist with early diagnosis to decrease mortality. Various other indicators such as levels of lactate dehydrogenase, D-dimer, potassium, pH, ischemia-modified albumin, urine, and fatty acid-binding proteins have also been described [3][4][5][6][7][8][9][10][11]. Reports that D-dimer, potassium, and pH can guide the early diagnosis of AMI have gained recent attention [4,[11][12][13].…”

Extracellular acidosis and very low [Na+] inhibit NBCn1- and NHE1-mediated net acid extrusion from mouse vascular smooth muscle cells

“…In addition to inhibition of Na + -coupled net acid extrusion by low pH o (Figs 2 and 3), Na + /H + exchange in VSMCs is inhibited by reactive oxygen species 12 and ATP depletion. 8 These transport-inactivating mechanism are likely prominent during ischaemia and reperfusion 26,27,69 where they could contribute to protection against Na + overload and consequent cell damage. The suggestion that VSMCs prefer regulation of [Na + ] i to regulation of pH i is consistent with reported irreversible hypercontracture and cardiomyocyte death caused by cellular Na + and Ca 2+ overload.…”

“…16 In addition to the signalling pathways highlighted above, it is likely that variations in extracellular (o) [Na + ], [HCO À 3 ] and/or pH modify the activity of NBCn1 and NHE1 although the sensitivity to disturbances in each of these parameters has not previously been determined in VSMCs. [23][24][25] Ischaemia also causes extracellular acidification, as illustrated by the decrease of peritoneal fluid pH to 6.7 during mesenteric ischaemia 26 and interstitial pH to 6.9 during cardiac ischaemia. 19 Water intoxication can lower [Na + ] o to the range 110-125 mM.…”

“…[20][21][22] In animal studies, local [Na + ] o can decrease to 45-70 mM during hypoxia and ischaemia. [23][24][25] Ischaemia also causes extracellular acidification, as illustrated by the decrease of peritoneal fluid pH to 6.7 during mesenteric ischaemia 26 and interstitial pH to 6.9 during cardiac ischaemia. 27 NHE1 contributes to pH i regulation in virtually all cell types, 28 and NBCn1 also has a broad expression profile: 29 outside the vascular wall, NBCn1 is expressed and functionally important, for instance, in the renal thick ascending limb of the loop of Henle, 30 hippocampal neurones 31 and cardiac myocytes.…”