Abdominal Hypertension and Decompression: The Effect on Peritoneal Metabolism in an Experimental Porcine Study

作者：Skoog P^*; Horer T M; Nilsson K F; Norgren L; Lasrzon T; Jansson K

来源：European Journal of Vascular and Endovascular Surgery, 2014, 47(4): 402-410.

DOI：10.1016/j.ejvs.2014.01.007

• Glycerol
• Intra-abdominal hypertension
• Lactate
• Laser Doppler flowmetry
• Microdialysis
• Pyruvate

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.

• 出版日期2014-4