The effect of glutamine on oxidative damage in an experimental abdominal compartment syndrome model in rats
Turkish Journal of Trauma and Emergency Surgery
The effect of glutamine on oxidative damage in an experimental abdominal compartment syndrome model in rats Dear Editor, We read with great interest the article by Tihan D et al., regarding an experimental study about The effect of glutamine on oxidative damage in an experimental abdominal compartment syndrome model in rats.  We would like to congratulate the authors for their grate work which is very innovative. However, it would be very informative if the authors could provide details
... rovide details regarding the sacrification time of their groups. How did the author chose sacrification time (time frame)? As we know in literature date, Abdominal compartment sendrome is emergency disease which effects many organ in the abdomen. The author chose 3th day after compartment sendome.It would be to long for seeing early damages in abdominal organ. The data is very clear from large studies that there is a correlation between elevated intra-abdominal pressure and worse outcome in terms of organ failure, ICU length of stay and mortality. Malbrain et al in 2005 demonstrated this conclusively in a multicenter trial showing even "mild" elevations of IAP (>12 mmHg) lead to worse outcomes probably due to the prolonged organ ischemia that occurs.  Sugrue et al.  in 1999 showed elevated IAP (over 18 mm Hg) was an independent predictor of renal failure, ranking up with hypotension, age and sepsis. Vidal  found 64% of patients in a mixed ICU population had IAH, which was an independent risk factor for organ dysfunction and death. Pupelis prospectively collected IAP and outcome data on pancreatitis patients and also found significant differences in outcomes. Those patients with IAP less than 18 mmHg had no mortality, 19% incidence of MODS/ SIRS and mean ICU length of stay of 9 days whereas patients with IAP greater than 18 mmHg had 36% mortality, 64% incidence of MODS/SIRS and mean ICU length of stay of 21 days. [5, 6] They conclude "The critical IAP values... with the best sensitivity specificity, were 23 mmHg for postoperative ventilatory delayed weaning (p<.05), 24 mm Hg for renal dysfunction (p<.05), and 25 mmHg for death (p<.01).