Porcine Model of Ruptured Abdominal Aortic Aneurysm Repair

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• 作者：P. Suk^a ; I. Cundrle Jr.^a ; J. Hruda^a ; L. Vocilková ; ^a ; Z. Konecny^b ; M. Vlasin^c ; M. Matejovic^d ; M. Pavlik^a ; V. Zvoní ; 膷ek^a ; V. Sramek^a ; ^{vladimir.sramek@fnusa.cz}
• 关键词：Ruptured aortic aneurysm ; Haemorrhage ; Intra-abdominal hypertension ; Experimental
• 刊名：European Journal of Vascular and Endovascular Surgery
• 出版年：2012
• 期刊代码：122_10785884
• 类别：med
• 出版时间：June, 2012
• 卷：43
• 期：6
• 页码：698-704
• 文件大小：495 K

摘要

4 class="h4">Objectives4>To validate a porcine model of ruptured abdominal aortic aneurysm (rAAA) repair.4 class="h4">Design4>

Experimental study.4 class="h4">Methods4>

Ten experimental and five sham-operated pigs were studied. Instrumentation for cardiac output (CO) measurement, regional blood flow (renal-REN and portal-PORT) and blood sampling (inferior vena cava (IVC), renal and portal vein) was done. Microcirculation was visualised sublingually and in ileostoma. Protocol: simulation of rAAA with bleeding (mean arterial pressure (MAP) 45聽mmHg) and increased abdominal pressure (25聽mmHg) for 4聽h; 2聽h of infrarenal clamp with shed blood retransfusion; 11聽h of post-surgery care.4 class="h4">Results4>

Six experimental pigs completed the protocol and are presented. Bleeding decreased CO to 95%, PORT to 80%and REN to 10%of baseline. From clamping on CO and PORT increased above baseline whereas REN (47%) with creatinine clearance remained compromised till the end. Microcirculation was affected more in ileum than sublingually. Approximately threefold increase in cytokines (tumour necrosis factor-伪 (TNF-alpha), interleukin (IL)-6 and IL-10) and oxidative stress markers (thiobarbituric acid-reactive substances (TBARs) and 4-hydroxy-2-trans-nonenal (HNE) was observed. Only mild increase in IL-6 and TBARs was observed in sham-operated animals. Organ histology did not reveal differences between groups.4 class="h4">Conclusions4>

This near-lethal model of rAAA induced expected severe deterioration of haemodynamics and metabolism accompanied with a moderate inflammatory and oxidative stress response.