title: Intra-peritoneal microdialysis and intra-abdominal pressure after endovascular repair of ruptured aortic aneurysms.
abstract: OBJECTIVE
  This study aims to evaluate intra-peritoneal (ip) microdialysis after endovascular aortic repair (EVAR) of ruptured abdominal aortic aneurysm (rAAA) in patients developing intra-abdominal hypertension (IAH), requiring abdominal decompression.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  A total of 16 patients with rAAA treated with an emergency EVAR were followed up hourly for intra-abdominal pressure (IAP), urine production and ip lactate, pyruvate, glycerol and glucose by microdialysis, analysed only at the end of the study. Abdominal decompression was performed on clinical criteria, and decompressed (D) and non-decompressed (ND) patients were compared.
  
  
  RESULTS
  The ip lactate/pyruvate (l/p) ratio was higher in the D group than in the ND group during the first five postoperative hours (mean 20 vs. 12), p = 0.005 and at 1 h prior to decompression compared to the fifth hour in the ND group (24 vs. 13), p = 0.016. Glycerol levels were higher in the D group during the first postoperative hours (mean 274.6 vs. 121.7 μM), p = 0.022. The IAP was higher only at 1 h prior to decompression in the D group compared to the ND group at the fifth hour (mean 19 vs. 14 mmHg).
  
  
  CONCLUSIONS
  Ip l/p ratio and glycerol levels are elevated immediately postoperatively in patients developing IAH leading to organ failure and subsequent abdominal decompression.
authors.affiliation: Department of Cardio-Thoracic and Vascular Surgery, Örebro University Hospital and Örebro University, Örebro, Sweden. tal.horer@orebroll.se
authors.forename: T M
authors.initials: TM
authors.lastname: Hörer
authors.forename: P
authors.initials: P
authors.lastname: Skoog
authors.forename: L
authors.initials: L
authors.lastname: Norgren
authors.forename: A
authors.initials: A
authors.lastname: Magnuson
authors.forename: L
authors.initials: L
authors.lastname: Berggren
authors.forename: K
authors.initials: K
authors.lastname: Jansson
authors.forename: T
authors.initials: T
authors.lastname: Larzon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D015415:Biomarkers / Q000378:metabolism; D019299:Decompression, Surgical; D042241:Early Diagnosis; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D005947:Glucose / Q000378:metabolism; D005990:Glycerol / Q000378:metabolism*; D006801:Humans; D059325:Intra-Abdominal Hypertension / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery; D019344:Lactic Acid / Q000378:metabolism*; D008297:Male; D017551:Microdialysis; D008875:Middle Aged; D010529:Peritoneal Cavity; D011237:Predictive Value of Tests; D011312:Pressure; D019289:Pyruvic Acid / Q000378:metabolism*; D013997:Time Factors; D016896:Treatment Outcome; D014554:Urination
chemical_list: D015415:Biomarkers; D019344:Lactic Acid; D019289:Pyruvic Acid; D005947:Glucose; D005990:Glycerol