Temporal differences in the development of organ dysfunction based on two different approaches to induce experimental intra-abdominal hypertension in swine.

Abstract

BACKGROUND:

Intra-abdominal hypertension [IAH] occurs frequently among critically ill patients and is associated with increased mortality and organ failure. Two porcine models of IAH that cause abdominal compartment syndrome [ACS] with organ dysfunction were created. We investigated whether the two methods used to create IAH - CO2 pneumoperitoneum or adding volume to the intra-abdominal space - exerted different impacts on the temporal development of organ dysfunction.

METHODS:

Twenty-four 40-kg female pigs were allocated to four groups: 25 mmHg IAH with CO2 pneumoperitoneum (n = 8), >20 mmHg IAH caused by addition of volume (n = 8), and two corresponding sham groups (each n = 4). The two sham groups were later pooled into one control group (n = 8). The animals were monitored for 12 h. Repeated serial measurements were taken of group differences over time and analyzed using analysis of variance.

RESULTS:

Thirty-eight percent of the animals (n = 3) in each intervention group died near the end of the 12-h experiment. Both intervention groups experienced kidney impairment: increased creatinine concentration (P <0.0001), anuria (P = 0.0005), hyperkalemia (P <0.0001), decreased abdominal perfusion pressure, and decreased dynamic lung compliance. CO2 pneumoperitoneum animals developed hypercapnia (P <0.0001) and acidosis (P <0.0001).

CONCLUSIONS:

Both methods caused ACS and organ dysfunction within 12 h. Hypercapnia and acidosis developed in the CO2 pneumoperitoneum group.

• Authors: Michael Moller, Ulrik K Kjerkegaard, Jens Larsen, Hanne Birke-Sorensen, Lars B Stolle
• Journal: Annals of intensive care (Ann Intensive Care) Vol. 2 Issue Suppl 1 Pg. S16 (Jul 05 2012) ISSN: 2110-5820 [Print] Germany
• PMID: 24266989 (Publication Type: Journal Article)