Effects of stomach inflation on haemodynamic and pulmonary function during spontaneous circulation in pigs.
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.
Paal
Peter
P
Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria. peter.paal@uki.at
Neurauter
Andreas
A
Loedl
Michael
M
Brandner
Julia
J
Herff
Holger
H
Knotzer
Hans
H
Mitterlechner
Thomas
T
von Goedecke
Achim
A
Bale
Reto
R
Lindner
Karl H
KH
Wenzel
Volker
V
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