大鼠腹腔内压力与早期肠道缺血之间的关系。

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

作者信息

Strang Steven G, van der Hoven Ben, Monkhorst Kim, Ali Samir, van Lieshout Esther M M, van Waes Oscar J F, Verhofstad Michael H J

机构信息

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

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

出版信息

Trauma Surg Acute Care Open. 2020 Dec 1;5(1):e000595. doi: 10.1136/tsaco-2020-000595. eCollection 2020.

DOI:10.1136/tsaco-2020-000595

PMID:33305007

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7709516/

Abstract

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

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

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

Although increasing IAP was associated with respiratory and hemodynamic difficulties, no signs for intestinal ischemia were found.

LEVEL OF EVIDENCE

Prognostic and epidemiologic study, level II.

摘要

背景

关于腹内压（IAP）升高的早期不可逆影响，人们了解甚少。因此，对于腹腔间隔室综合征患者，进行腹腔减压的时机仍然具有挑战性。本研究的目的是确定IAP与呼吸参数、血流动力学参数以及早期肠道缺血之间的关系。

方法

将25只麻醉并通气的雄性Sprague-Dawley大鼠随机分为五组，分别暴露于0、5、10、15或20 mmHg的IAP下3小时。测定呼吸参数、血流动力学参数以及作为全身缺血指标的血清白蛋白-钴结合（ACB）能力。对肠道进行组织病理学处理。

结果

IAP与90分钟时的平均动脉压呈负相关（Spearman相关系数；Rs = -0.446，p = 0.025）以及180分钟时的平均动脉压呈负相关（Rs = -0.466，p = 0.019），与90分钟时的氧饱和度呈负相关（Rs = -0.673，p < 0.001）以及180分钟时的氧饱和度呈负相关（Rs = -0.882，p < 0.001），与90分钟时的pH值呈负相关（Rs = -0.819，p < 0.001）以及180分钟时的pH值呈负相关（Rs = -0.934，p < 0.001）。IAP与乳酸水平或ACB能力之间无关联。未发现肠道缺血的组织学迹象。