Seo Daeyun, Lim Seongsoo, Namgoong Beomkwan, Uhm Heesung, Hong Hyeajeong, Lee Nanju, Kim Isong, Heo Seunghun, Kang Ji Hwan, Kim Cheyoun, Shin Hayoung, Her Jiwoong, Kim Min Su
Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research institute for Veterinary Science, Seoul National University, Seoul, South Korea.
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, United States of America.
PLoS One. 2024 Dec 12;19(12):e0315491. doi: 10.1371/journal.pone.0315491. eCollection 2024.
Liver compression (LC) has been proposed to predict fluid responsiveness in human pediatric patients. Because the evaluation of fluid responsiveness through LC depends on the mechanism of increased intra-abdominal pressure (IAP), understanding the impact of LC on IAP, cardiac output (CO), and respiratory parameters is essential. Thus, this study aimed to investigate the effects of LC on these parameters.
The present study used six healthy beagles. All dogs were anesthetized with isoflurane and allowed to breathe spontaneously in dorsal recumbency. After instrumentation, LC was performed at four different pressures in a sequential, non-randomized manner: (1) 10 mmHg, approximately half of the minimum value within the range; (2) 22 mmHg, a commonly used pressure within the range; (3) 44 mmHg, twice the pressure of the minimum value within the range; and (4) 60 mmHg, twice the pressure of the maximum value within the range. At each pressure, CO via transthoracic echocardiography, IAP, and cardiorespiratory parameters were measured before, during, and after LC.
Overall, our results showed that the IAP was significantly increased at all pressures during LC (P < 0.001), yielding a linear correlation between LC pressure and IAP (P < 0.001; r² = 0.89). The maximum IAP during LC was 7 mmHg, and intra-abdominal hypertension was not induced. LC at 22 mmHg significantly increased the IAP by 1.7 mmHg, but did not significantly alter the CO or respiratory parameters.
This is the first study to evaluate the effects of LC on IAP, CO, and respiratory parameters in healthy, anesthetized, and spontaneously breathing dogs. Our findings indicate that applying LC with a commonly used pressure may have a low risk of inducing intra-abdominal hypertension and related complications. Further studies are required to explore the use of LC in various clinical settings.
肝脏压迫（LC）已被提出用于预测小儿患者的液体反应性。由于通过LC评估液体反应性取决于腹腔内压力（IAP）升高的机制，了解LC对IAP、心输出量（CO）和呼吸参数的影响至关重要。因此，本研究旨在探讨LC对这些参数的影响。
本研究使用了6只健康的比格犬。所有犬只均用异氟醚麻醉，并使其在背卧位自主呼吸。仪器安装后，以非随机顺序在四个不同压力下进行LC：（1）10 mmHg，约为该范围内最小值的一半；（2）22 mmHg，该范围内常用的压力；（3）44 mmHg，该范围内最小值压力的两倍；（4）60 mmHg，该范围内最大值压力的两倍。在每个压力下，在LC之前、期间和之后测量经胸超声心动图测得的CO、IAP和心肺参数。
总体而言，我们的结果表明，在LC期间所有压力下IAP均显著升高（P < 0.001），LC压力与IAP之间呈线性相关（P < 0.001；r² = 0.89）。LC期间的最大IAP为7 mmHg，未诱发腹腔内高压。22 mmHg的LC使IAP显著升高1.7 mmHg，但未显著改变CO或呼吸参数。
这是第一项评估LC对健康、麻醉且自主呼吸犬的IAP、CO和呼吸参数影响的研究。我们的研究结果表明，以常用压力应用LC可能诱发腹腔内高压及相关并发症的风险较低。需要进一步研究以探索LC在各种临床环境中的应用。
