title: Abdominal hypertension and decompression: the effect on peritoneal metabolism in an experimental porcine study.
abstract: OBJECTIVE
  The aim of this study was to investigate the abdominal metabolic response and circulatory changes after decompression of intra-abdominal hypertension in a porcine model.
  
  
  METHODS
  This was an experimental study with controls. Three-month-old domestic pigs of both sexes were anesthetized and ventilated. Nine animals had a pneumoperitoneum-induced IAH of 30 mmHg for 6 hours. Twelve animals had the same IAH for 4 hours followed by decompression, and were monitored for another 2 hours. Hemodynamics, including laser Doppler-measured mucosal blood flow, urine output, and arterial blood samples were analyzed every hour along with glucose, glycerol, lactate and pyruvate concentrations, and lactate-pyruvate (l/p) ratio, measured by microdialysis.
  
  
  RESULTS
  Laser Doppler-measured mucosal blood flow and urine output decreased with the induction of IAH and showed a statistically significant resolution after decompression. Both groups developed distinct metabolic changes intraperitoneally on induction of IAH, including an increased l/p ratio, as signs of organ hypoperfusion. In the decompression group the intraperitoneal l/p ratio normalized during the second decompression hour, indicating partially restored perfusion.
  
  
  CONCLUSIONS
  Decompression after 4 hours of IAH results in an improved intestinal blood flow and a normalized intraperitoneal l/p ratio.
authors: Department of Cardio-Thoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden. Electronic address: per.skoog@orebroll.se.
authors: P
authors: P
authors: Skoog
authors: Department of Cardio-Thoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.
authors: T M
authors: TM
authors: Hörer
authors: Department of Cardio-Thoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.
authors: K F
authors: KF
authors: Nilsson
authors: Department of Surgery, Örebro University Hospital, Örebro, Sweden.
authors: L
authors: L
authors: Norgren
authors: Department of Cardio-Thoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.
authors: T
authors: T
authors: Larzon
authors: Department of Surgery, Örebro University Hospital, Örebro, Sweden.
authors: K
authors: K
authors: Jansson
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D019299:Decompression, Surgical / Q000379:methods; D004195:Disease Models, Animal; D005260:Female; D005947:Glucose / Q000378:metabolism; D006439:Hemodynamics; D059325:Intra-Abdominal Hypertension / Q000378:metabolism* / Q000601:surgery*; D019344:Lactic Acid / Q000378:metabolism; D008297:Male; D017551:Microdialysis / Q000379:methods; D019289:Pyruvic Acid / Q000378:metabolism; D013552:Swine
chemical_list: D019344:Lactic Acid; D019289:Pyruvic Acid; D005947:Glucose
keywords: Glycerol; Intra-abdominal hypertension; Lactate; Laser Doppler flowmetry; Microdialysis; Pyruvate