The effect of intra-abdominal hypertension alone or combined intra-abdominal hypertension-endotoxemia in cerebral oxygenation in a porcine model.
BACKGROUND
Abdominal compartment syndrome (ACS) has been recognized as an entity, affecting cardiovascular, pulmonary, and cerebral function, while it is often complicated with sepsis. Goal of the study was the evaluation of brain oxygenation during ACS alone and in combination with endotoxinemia.


METHODS
Sixteen pigs, undergone intra-abdominal hypertension, were allocated to receive intravenous administration of either saline or endotoxin. Pigs were evaluated regarding brain tissue oxygenation (PbrO2), systemic oxygenation (PaO2) and regional cerebral blood flow (rCBF).


RESULTS
Statistical analysis revealed significant reduction of PbrO2 over time for sepsis group, after endotoxin administration. Regarding differences between groups, sepsis group experienced lower PbrO2 values, compared to saline group, only after endotoxin administration. Both groups experienced reduction in arterial oxygenation, with greater pertubations seen after sepsis induction. Regarding rCBF, septic pigs showed greater flow values, while ACS alone did not influence rCBF. ACS has no deleterious effects in cerebral oxygenation and flow, provided systemic oxygenation and CPP are maintained above normal value.


CONCLUSIONS
Combined sepsis-ACS lead to perturbations in cerebral oxygenation, in conjunction with greater rCBF values. The latter could be ascribed to abnormalities in oxygen extraction.
Karakoulas
K
K
Department of Anesthesia and Intensive Care, AHEPA University Hospital, and Department of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Greece.
Grosomanidis
V
V
Amaniti
E
E
Kouvelas
D
D
Skourtis
C
C
Vasilakos
D
D