Abdominal Hypertension and Decompression: The Effect on Peritoneal Metabolism in an Experimental Porcine Study
2014 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 47, no 4, 402-410 p.Article in journal (Refereed) Published
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.
Place, publisher, year, edition, pages
W.B. Saunders Ltd , 2014. Vol. 47, no 4, 402-410 p.
Glycerol, Intra-abdominal hypertension, Lactate, Laser Doppler flowmetry, Microdialysis, Pyruvate
Surgery Cardiac and Cardiovascular Systems
IdentifiersURN: urn:nbn:se:oru:diva-56730DOI: 10.1016/j.ejvs.2014.01.007ISI: 000333855900012PubMedID: 24530179ScopusID: 2-s2.0-84896096610OAI: oai:DiVA.org:oru-56730DiVA: diva2:1083938
Medical Research Council in Örebro, Sweden
Nyckelfonden, Örebro, Sweden2017-03-232017-03-232017-03-23Bibliographically approved