title: Effects of stomach inflation on haemodynamic and pulmonary function during spontaneous circulation in pigs.
abstract: OBJECTIVE
  Stomach inflation during mask ventilation is frequent, but the effects on haemodynamic and pulmonary function are unclear. We evaluated the effects of stomach inflation on haemodynamic and pulmonary function during spontaneous circulation in a porcine model.
  
  
  METHODS
  Randomised prospective animal study. After randomisation, in 23 domestic pigs the stomach was inflated every 90s with 0L (control; n=8), 0.5L (n=7) or 1L (n=8) ambient air.
  
  
  RESULTS
  After 22.5min, i.e. 8.5L in the 0.5L and 17L in the 1L stomach inflation group, stomach inflation increased central venous pressure (median) (control: 10mmHg vs. 1L: 23mmHg, P<0.05) and mean pulmonary artery pressure (control: 24mmHg vs. 1L: 45mmHg, P<0.05). As a result stroke volume index decreased (control: 135mL/kg vs. 0.5L: 90mL/kg, P<0.05; vs. 1L: 72mL/kg, P<0.05). Stomach inflation also decreased static pulmonary compliance (control: 24mL/cmH(2)O vs. 0.5L: 8mL/cmH(2)O, P<0.05; vs. 1L: 3mL/cmH(2)O, P<0.05), which increased peak airway pressure (control: 28cmH(2)O vs. 0.5L: 69cmH(2)O, P<0.05; vs. 1L: 73cmH(2)O, P<0.05). Additionally, arterial oxygen partial pressure (control: 305mmHg vs. 0.5L: 140mmHg, P<0.05; vs. 1L: 21mmHg, P<0.05) and systemic oxygen delivery (control: 53mLO(2)/min vs. 1L: 19mLO(2)/min, P<0.05) decreased. Stomach inflation increased mortality (control: 0/8 vs. 1L: 5/8, P<0.05).
  
  
  CONCLUSIONS
  Stomach inflation with 1L when compared to 0.5L increments resulted in faster haemodynamic and pulmonary failure and increased mortality. Stomach inflation may cause a hyper-acute abdominal compartment syndrome.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria. peter.paal@uki.at
authors.forename: Peter
authors.initials: P
authors.lastname: Paal
authors.forename: Andreas
authors.initials: A
authors.lastname: Neurauter
authors.forename: Michael
authors.initials: M
authors.lastname: Loedl
authors.forename: Julia
authors.initials: J
authors.lastname: Brandner
authors.forename: Holger
authors.initials: H
authors.lastname: Herff
authors.forename: Hans
authors.initials: H
authors.lastname: Knotzer
authors.forename: Thomas
authors.initials: T
authors.lastname: Mitterlechner
authors.forename: Achim
authors.initials: A
authors.lastname: von Goedecke
authors.forename: Reto
authors.initials: R
authors.lastname: Bale
authors.forename: Karl H
authors.initials: KH
authors.lastname: Lindner
authors.forename: Volker
authors.initials: V
authors.lastname: Wenzel
mesh_terms: D000005:Abdomen; D000818:Animals; D002496:Central Venous Pressure / Q000502:physiology; D003161:Compartment Syndromes / Q000209:etiology; D005260:Female; D007327:Insufflation / Q000009:adverse effects*; D008170:Lung Compliance / Q000502:physiology; D008297:Male; D012123:Pulmonary Ventilation / Q000502:physiology; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D013270:Stomach; D013318:Stroke Volume / Q000502:physiology; D013552:Swine