Dabrowski Wojciech
Department of Anesthesiology and Intensive Therapy, Feliks Skubiszewski Medical University of Lublin, Poland.
Med Sci Monit. 2007 Dec;13(12):CR548-54.
The aim was to analyze IAP changes and the relationships between IAP, CVP, and brain venous blood pressure, which are still unknown, in patients undergoing coronary artery bypass grafting (CABG) with extracorporeal circulation.
MATERIAL/METHODS: Twenty-five male patients (aged 53-67 years) underwent CABG under general anesthesia with normovolemic hemodilution. IAPs were measured in the urinary bladder, CVP by left internal jugular vein cannulation, and brain venous blood pressure by retrograde cannulation of the right jugular vein bulb (JVP, jugular vein pressure) at seven time-points: 1) after induction of anesthesia before the operation, 2) during internal thoracic artery preparation, 3) 10 minutes after heart-lung machine disconnection, 4) after procedure completion, before sending the patient to the intensive postoperative care unit, 5) one hour after the procedure, 6) 6 hours after the procedure, and 7) 18 hours after the procedure.
IAP increased from points 3 to 6. CVP increased from points 3, 4, and 5 and decreased at point 7. Similar changes were noted in JVP. There were significant correlations between IAP and CVP at points 1, 2, 3, 4, and 5, IAP and JVP at points 3, 4, and 5, and CVP and JVP at all points. The overall analysis showed correlations between IAP and CVP and JVP and very strong correlation between CVP and JVP.
目的是分析在接受体外循环冠状动脉搭桥术（CABG）的患者中腹内压（IAP）的变化以及IAP、中心静脉压（CVP）和脑静脉血压之间仍不明确的关系。
材料/方法：25例男性患者（年龄53 - 67岁）在全身麻醉下行CABG并进行等容血液稀释。在七个时间点测量膀胱内IAP、通过左颈内静脉插管测量CVP以及通过右颈静脉球逆行插管测量脑静脉血压（JVP，颈静脉压）：1）麻醉诱导后手术前；2）胸廓内动脉准备期间；3）心肺机停机后10分钟；4）手术完成后，将患者送至术后重症监护病房之前；5）手术后1小时；6）手术后6小时；7）手术后18小时。
IAP从第3个时间点到第6个时间点升高。CVP在第3、4和5个时间点升高，在第7个时间点降低。JVP也有类似变化。在第1、2、3、4和5个时间点IAP与CVP之间、第3、4和5个时间点IAP与JVP之间以及所有时间点CVP与JVP之间存在显著相关性。总体分析显示IAP与CVP和JVP之间存在相关性，CVP与JVP之间存在非常强的相关性。
1）体外循环冠状动脉搭桥术导致IAP、CVP和脑静脉血压升高。2）CVP和脑静脉血压的变化与腹内压相关。
