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Abdominal Hypertension and Decompression: The Effect on Peritoneal Metabolism in an Experimental Porcine Study
Department of Cardio-Thoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.
Region Örebro län. Department of Cardio-Thoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.
Region Örebro län. Department of Cardio-Thoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.ORCID-id: 0000-0002-8461-5074
Department of Surgery, Örebro University Hospital, Örebro, Sweden.
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2014 (Engelska)Ingår i: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 47, nr 4, s. 402-410Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: The aim of this study was to investigate the abdominal metabolic response and circulatory changes after decompression of intra-abdominal hypertension in a porcine model.

Methods: This was an experimental study with controls. Three-month-old domestic pigs of both sexes were anesthetized and ventilated. Nine animals had a pneumoperitoneum-induced IAH of 30 mmHg for 6 hours. Twelve animals had the same IAN for 4 hours followed by decompression, and were monitored for another 2 hours. Hemodynamics, including laser Doppler-measured mucosal blood flow, urine output, and arterial blood samples were analyzed every hour along with glucose, glycerol, lactate and pyruvate concentrations, and lactate-pyruvate (l/p) ratio, measured by microdialysis.

Results: Laser Doppler-measured mucosal blood flow and urine output decreased with the induction of IAH and showed a statistically significant resolution after decompression. Both groups developed distinct metabolic changes intraperitoneally on induction of IAH, including an increased l/p ratio, as signs of organ hypoperfusion. In the decompression group the intraperitoneal l/p ratio normalized during the second decompression hour, indicating partially restored perfusion.

Conclusion: Decompression after 4 hours of IAH results in an improved intestinal blood flow and a normalized intraperitoneal lip ratio.

Ort, förlag, år, upplaga, sidor
W.B. Saunders Ltd , 2014. Vol. 47, nr 4, s. 402-410
Nyckelord [en]
Glycerol, Intra-abdominal hypertension, Lactate, Laser Doppler flowmetry, Microdialysis, Pyruvate
Nationell ämneskategori
Kirurgi Kardiologi
Identifikatorer
URN: urn:nbn:se:oru:diva-56730DOI: 10.1016/j.ejvs.2014.01.007ISI: 000333855900012PubMedID: 24530179Scopus ID: 2-s2.0-84896096610OAI: oai:DiVA.org:oru-56730DiVA, id: diva2:1083938
Anmärkning

Funding Agencies:

Medical Research Council in Örebro, Sweden

Nyckelfonden, Örebro, Sweden

Tillgänglig från: 2017-03-23 Skapad: 2017-03-23 Senast uppdaterad: 2019-03-26Bibliografiskt granskad

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Hörer, Tal M.Nilsson, Kristofer F.Larzon, ThomasJansson, Kjell
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European Journal of Vascular and Endovascular Surgery
KirurgiKardiologi

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