Abstract
Intra-abdominal hypertension (IAH) can damage multiple organ systems, but the explicit impact on the adrenal gland is unclear. To evaluate the effects of intra-abdominal pressure (IAP) on the secretory function of the adrenal glands, we established canine models of IAH. By comparing morphology; hemodynamics; plasma cortisol, aldosterone, epinephrine, and norepinephrine concentrations; and the expression of IL-1, IL-6, and TNF-α in adrenal gland tissue from these dogs, we found that hemodynamic instability occurred after IAH and that IAH increased the plasma cortisol, aldosterone, epinephrine, and norepinephrine concentrations. Higher IAPs resulted in more significant changes, and the above indicators gradually returned to normal 2 h after decompression. Compared with the sham-operated group, IAH significantly increased IL-1, IL-6, and TNF-α levels in adrenal tissue, with larger increases in the presence of higher IAPs. However, the concentrations of these markers remained higher than those in the sham-operated group despite their decrease after 2 h of decompression. Histopathological examination revealed congestion, red blood cell exudation, and neutrophil infiltration in the adrenal glands when IAP was elevated; these conditions became more significant with more severe IAH. These results suggest that the secretion of adrenal hormones and adrenal gland inflammation are positively correlated with IAP and that abdominal decompression effectively corrects adrenal gland function.
Highlights
The abdomen is considered a closed box with rigid or flexible walls
Intra-abdominal hypertension (IAH) is defined as an intra-abdominal pressure (IAP) greater than or equal to 12 mmHg according to the consensus definition of the World Society of the Abdominal Compartment Syndrome [1]
Compared with the pre-IAH values, the cortisol, aldosterone, epinephrine, and norepinephrine levels gradually increased 0.5, 2, and 4 h after the induction of IAH, and more significant increases were observed as the IAP increased
Summary
The intra-abdominal pressure (IAP) is zero or negative under normal physiological conditions. The adrenal gland primarily secretes cortisol, aldosterone, epinephrine, and norepinephrine; this gland plays an important role in regulating metabolism and the stress response, maintaining blood volume, and influencing organ system function. Elevated IAP has a direct effect, via compression, on the adrenal glands and vessels. As a source of stress, IAP can alter the secretion of adrenal hormones. There has not been a definitive study on the effects of IAH on the adrenal glands and their secretory function or on the correlation between the extent and duration of IAH and the physiological effects on the adrenal glands. The present study aimed to determine the effects of IAH on the adrenal glands and to explore the effect of abdominal decompression on improving IAH-induced abnormal adrenal function
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