An increase of abdominal pressure increases pulmonary edema in oleic acid-induced lung injury.
Increased abdominal pressure is common in intensive care unit patients. To investigate its impact on respiration and hemodynamics we applied intraabdominal pressure (aIAP) of 0 and 20 cm H(2)O (pneumoperitoneum) in seven pigs. The whole-lung computed tomography scan and a complete set of respiratory and hemodynamics variables were recorded both in healthy lung and after oleic acid (OA) injury. In healthy lung, aIAP 20 cm H(2)O significantly lowered the gas content, leaving the tissue content unchanged. In OA-injured lung at aIAP 0 cm H(2)O, the gas content significantly decreased compared with healthy lung. The excess tissue mass (edema) amounted to 30 +/- 24% of the original tissue weight (455 +/- 80 g). The edema was primarily distributed in the base regions and was not gravity dependent. Heart volume, central venous, pulmonary artery, wedge, and systemic arterial pressures significantly increased. At aIAP 20 cm H(2)O in OA-injured lung, the central venous and pulmonary artery pressures further increased. The gas content further decreased, and the excess tissue mass rose up to 103 +/- 37% (tissue weight 905 +/- 134 g), with homogeneous distribution along the cephalocaudal and sternovertebral axis. We conclude that in OA-injured lung, the increase of IAP increases the amount of edema.
Quintel
Michael
M
Institut für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum, Mannheim, Mannheim, Germany.
Pelosi
Paolo
P
Caironi
Pietro
P
Meinhardt
Jurgen Peter
JP
Luecke
Thomas
T
Herrmann
Peter
P
Taccone
Paolo
P
Rylander
Christian
C
Valenza
Franco
F
Carlesso
Eleonora
E
Gattinoni
Luciano
L
D000005:Abdomen / Q000502:physiology*; D000818:Animals; D015633:Extravascular Lung Water / Q000000981:diagnostic imaging; D006439:Hemodynamics; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology; D008170:Lung Compliance; D019301:Oleic Acid; D011312:Pressure; D011654:Pulmonary Edema / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D011659:Pulmonary Gas Exchange; D012128:Respiratory Distress Syndrome / Q000139:chemically induced / Q000150:complications / Q000503:physiopathology*; D013552:Swine; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D019301:Oleic Acid