title: Blood oxygenation during hyperpressure intraperitoneal fluid administration in a rabbit model of severe liver injury: Evaluation of a novel concept for control of pre-hospital liver bleeding.
abstract: Oxygen is an essential part of the most important metabolic pathways in aerobic organisms. Oxygen delivery is merely dependent on blood, rendering blood loss a devastating event. Traumatic pre-hospital liver bleeding is a major cause of early trauma deaths in human and animals, with no established therapeutic method yet. Increasing intra-abdominal pressure (IAP) has been shown to reduce liver bleeding by half. Although reduction of blood loss could be in favor of blood oxygen delivery, however, the complex interaction between increased IAP and respiratory mechanics during severe hemorrhagic shock remained unclear. We used a novel model of liver trauma in 16 rabbits and randomly assigned them to either normotensive abdomen group or increased IAP by fluid infusion (HA) groups (n=8 each). Liver size and the amount of liver injury were evaluated. Various blood oxygenation parameters were recorded. Both groups were identical in terms of the liver size and injury. The HA group had significantly lower shock index. Arterial oxygen capacity and oxygen content were higher in the HA group. No significant statistical difference was seen between groups in terms of abdominal perfusion pressure; alveolar pressure of oxygen; dissolved oxygen in blood plasma; alveolar to arterial oxygen tension gradient; arterial to alveolar oxygen pressure ratio; the ratio between partial pressure of arterial oxygen and fraction of inspired oxygen; and respiratory index. In conclusion, the novel therapeutic method of increasing IAP by fluid infusion in a rabbit model of liver hemorrhage preserved blood oxygenation better than the classic therapeutic method.
authors: Department of Clinical Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.
authors: Siavash
authors: S
authors: Ahmadi-Noorbakhsh
authors: Department of Clinical Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.
authors: Saeed
authors: S
authors: Azizi
authors: Department of Clinical Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.
authors: Bahram
authors: B
authors: Dalir-Naghadeh
authors: Department of Clinical Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.
authors: Masoud
authors: M
authors: Maham
keywords: Hemorrhage; Intra-abdominal Hypertension; Liver; Pre-hospital Care; Rabbit
references: J Biomed Mater Res B Appl Biomater. 2009 Jul;90(1):45-54
references: 18988274
references: J Trauma. 2005 Dec;59(6):1305-8; discussion 1308
references: 16394901
references: J Trauma. 2003 Mar;54(3):590-4
references: 12634543
references: Acta Anaesthesiol Scand. 2002 May;46(5):552-60
references: 12027850
references: J Trauma. 2007 Aug;63(2):285-8; discussion 288-90
references: 17693825
references: Acta Anaesthesiol Scand. 2005 Jul;49(6):778-83
references: 15954959
references: Intensive Care Med. 2006 Nov;32(11):1722-32
references: 16967294
references: Crit Care Nurs Q. 2004 Oct-Dec;27(4):353-79
references: 15537123
references: Acta Anaesthesiol Scand Suppl. 1995;107:37-44
references: 8599295
references: J Trauma. 2000 Oct;49(4):621-6; discussion 626-7
references: 11038078
references: J Surg Res. 2012 Aug;176(2):559-66
references: 22172133
references: Crit Care. 2004;8 Suppl 2:S57-60
references: 15196327
references: World J Surg. 2000 Aug;24(8):1004-8
references: 10865049