Relation between intra-abdominal pressure and early intestinal ischemia in rats.

abdominal injuries animal experimentation compartment syndromes multiple trauma

Journal

Trauma surgery & acute care open
ISSN: 2397-5776
Titre abrégé: Trauma Surg Acute Care Open
Pays: England
ID NLM: 101698646

Informations de publication

Date de publication:
2020
Historique:
received: 27 08 2020
revised: 20 11 2020
accepted: 20 11 2020
entrez: 11 12 2020
pubmed: 12 12 2020
medline: 12 12 2020
Statut: epublish

Résumé

Little is known on early irreversible effects of increased intra-abdominal pressure (IAP). Therefore, timing of abdominal decompression among patients with abdominal compartment syndrome remains challenging. The study objective was to determine the relation between IAP and respiratory parameters, hemodynamic parameters, and early intestinal ischemia. Twenty-five anesthetized and ventilated male Sprague-Dawley rats were randomly assigned to five groups exposed to IAPs of 0, 5, 10, 15, or 20 mm Hg for 3 hours. Respiratory parameters, hemodynamic parameters, and serum albumin-cobalt binding (ACB) capacity as measure for systemic ischemia were determined. Intestines were processed for histopathology. IAP was negatively associated with mean arterial pressure at 90 (Spearman correlation coefficient; Rs=-0.446, p=0.025) and 180 min (Rs=-0.466, p=0.019), oxygen saturation at 90 min (Rs=-0.673, p<0.001) and 180 min (Rs=-0.882, p<0.001), and pH value at 90 (Rs=-0.819, p<0.001) and 180 min (Rs=-0.934, p<0.001). There were no associations between IAP and lactate level or ACB capacity. No histological signs for intestinal ischemia were found. Although increasing IAP was associated with respiratory and hemodynamic difficulties, no signs for intestinal ischemia were found. Prognostic and epidemiologic study, level II.

Sections du résumé

BACKGROUND BACKGROUND
Little is known on early irreversible effects of increased intra-abdominal pressure (IAP). Therefore, timing of abdominal decompression among patients with abdominal compartment syndrome remains challenging. The study objective was to determine the relation between IAP and respiratory parameters, hemodynamic parameters, and early intestinal ischemia.
METHODS METHODS
Twenty-five anesthetized and ventilated male Sprague-Dawley rats were randomly assigned to five groups exposed to IAPs of 0, 5, 10, 15, or 20 mm Hg for 3 hours. Respiratory parameters, hemodynamic parameters, and serum albumin-cobalt binding (ACB) capacity as measure for systemic ischemia were determined. Intestines were processed for histopathology.
RESULTS RESULTS
IAP was negatively associated with mean arterial pressure at 90 (Spearman correlation coefficient; Rs=-0.446, p=0.025) and 180 min (Rs=-0.466, p=0.019), oxygen saturation at 90 min (Rs=-0.673, p<0.001) and 180 min (Rs=-0.882, p<0.001), and pH value at 90 (Rs=-0.819, p<0.001) and 180 min (Rs=-0.934, p<0.001). There were no associations between IAP and lactate level or ACB capacity. No histological signs for intestinal ischemia were found.
DISCUSSION CONCLUSIONS
Although increasing IAP was associated with respiratory and hemodynamic difficulties, no signs for intestinal ischemia were found.
LEVEL OF EVIDENCE METHODS
Prognostic and epidemiologic study, level II.

Identifiants

pubmed: 33305007
doi: 10.1136/tsaco-2020-000595
pii: tsaco-2020-000595
pmc: PMC7709516
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e000595

Informations de copyright

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Steven G Strang (SG)

Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Ben van der Hoven (B)

Department of Intensive Care Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Kim Monkhorst (K)

Department of Pathology, Josephine Nefkens Institute, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Samir Ali (S)

Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Esther M M van Lieshout (EMM)

Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Oscar J F van Waes (OJF)

Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Michael H J Verhofstad (MHJ)

Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Classifications MeSH