- 作者：Laura Correa-Mart铆n ; Gregorio Castellanos ; M贸nica Garc铆a-Lindo ; Idoia D铆az-G眉emes ; Antonio Pi帽ero ; Francisco Miguel S谩nchez-Margallo
- 关键词：Presió ; n intraabdominal ; Hipertensió ; n intraabdominal ; Perfusió ; n ; Tonometrí ; a ; Experimental ; Ascitis
- 刊名：Gastroenterolog铆a y Hepatolog铆a
- 出版年：February, 2014
- 年：2014
- 卷：37
- 期：2
- 页码：51-57
- 全文大小：949 K
Introduction
Intra-abdominal hypertension is defined as a rise in intra-abdominal pressure leading to progressive dysfunction of the abdominal organs.
Objective
To evaluate the effects of intra-abdominal hypertension on the splanchnic circulation in a porcine animal model with a view to determining the diagnostic method of choice.
Material and methods
A total of 10 swine were divided into 2 groups: a control group and a group with an ascites pressure of 20 mmHg. Transvesical and transperitoneal intra-abdominal pressures were registered, and the correlation between the measurements obtained was determined. Concentrations of lactic acid, alanine aminotransferase, glucose and gastric mucosal pH were also obtained. We registered the mean arterial and abdominal perfusion pressures, and the correlation of the latter with gastric mucosal pH and lactic acid concentrations. The parameters were registered for a total of 3 hours.
Results
We observed a high correlation between transvesical and transperitoneal measurements of intra-abdominal pressure (R2 = 0.98). In the 20 mmHg pressure group, lactic acid concentrations increased significantly at 180 min (p < 0.011). Gastric mucosal pH differed significantly between the 2 groups from the beginning of the study (p = 0.004) and significantly decreased from 120 min onward. Mean arterial and abdominal perfusion pressures gradually decreased during the trial, with early significant changes in the abdominal perfusion pressure (p = 0.001), and a good correlation with the remaining study parameters. There were no significant changes in hepatic indicators.
Conclusions
We believe the transvesical approach to be the technique of choice to determine intra-abdominal pressure. Abdominal perfusion pressure is a sensitive marker of intra-abdominal hypertension, and gastric mucosal pH is the first parameter to be affected.