title: Evaluating the effects of immediate application of negative pressure therapy after decompression from abdominal compartment syndrome in an experimental porcine model.
abstract: OBJECTIVE
  The purpose of this large-animal study was to assess the safety and effects of negative pressure therapy (NPT) when used as temporary abdominal closure in the immediate post-decompression period after abdominal compartment syndrome (ACS).
  
  
  METHODS
  Using a hemorrhagic shock/resuscitation and mesenteric venous pressure elevation model, ACS was physiologically induced in 12 female Yorkshire swine. At decompression, animals were allocated to either NPT (n = 6) or Bogota bag (n = 6) as temporary abdominal closure and studied for a period of 48 h or until death. Outcomes measured included morbidity and mortality, as well as hemodynamic parameters, ventilator-related measurements, blood gases, coagulation factors, and organ (liver, kidney, lung, and intestinal) edema and histology at the time of death/sacrifice.
  
  
  RESULTS
  All animals developed ACS. Early application of NPT was associated with decreases in mesenteric venous and central venous pressure, and significantly increased drainage of peritoneal fluid. In addition, there was no increase in the incidence of mortality, recurrent intra-abdominal hypertension/ACS, or any deleterious effects on markers of organ injury.
  
  
  CONCLUSIONS
  Early application of NPT in this porcine ACS model is safe and does not appear to be associated with an increased risk of recurrent intra-abdominal hypertension. The results of this animal study suggest that the application of NPT following decompression from ACS results in greater peritoneal fluid removal and may translate into augmented intestinal edema resolution secondary to more favorable fluid flux profiles.
authors.affiliation: Departments of Pediatric Surgery and Surgery, University of Texas Medical School at Houston, 6431 Fannin Street, MSB 5.236, Houston, TX, 77030, USA.|Michael E. DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, TX, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Shah
authors.affiliation: Departments of Pediatric Surgery and Surgery, University of Texas Medical School at Houston, 6431 Fannin Street, MSB 5.236, Houston, TX, 77030, USA.
authors.forename: F
authors.initials: F
authors.lastname: Jimenez
authors.affiliation: Departments of Pediatric Surgery and Surgery, University of Texas Medical School at Houston, 6431 Fannin Street, MSB 5.236, Houston, TX, 77030, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: Walker
authors.affiliation: Departments of Pediatric Surgery and Surgery, University of Texas Medical School at Houston, 6431 Fannin Street, MSB 5.236, Houston, TX, 77030, USA.
authors.forename: H
authors.initials: H
authors.lastname: Xue
authors.affiliation: Kinetic Concepts, Inc., San Antonio, TX, USA.
authors.forename: T D
authors.initials: TD
authors.lastname: Feeley
authors.affiliation: Departments of Pediatric Surgery and Surgery, University of Texas Medical School at Houston, 6431 Fannin Street, MSB 5.236, Houston, TX, 77030, USA.|Michael E. DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, TX, USA.
authors.forename: K S
authors.initials: KS
authors.lastname: Uray
authors.affiliation: Kinetic Concepts, Inc., San Antonio, TX, USA.
authors.forename: K C
authors.initials: KC
authors.lastname: Norbury
authors.affiliation: Michael E. DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, TX, USA.
authors.forename: R H
authors.initials: RH
authors.lastname: Stewart
authors.affiliation: Michael E. DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, TX, USA.
authors.forename: G A
authors.initials: GA
authors.lastname: Laine
authors.affiliation: Departments of Pediatric Surgery and Surgery, University of Texas Medical School at Houston, 6431 Fannin Street, MSB 5.236, Houston, TX, 77030, USA. Charles.S.Cox@uth.tmc.edu.|Michael E. DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, TX, USA. Charles.S.Cox@uth.tmc.edu.
authors.forename: C S
authors.initials: CS
authors.lastname: Cox
keywords: Compartment syndrome; Decompression; Laparotomy; Negative pressure dressings
references.citation: J Trauma. 2003 Oct;55(4):734-40
references.pmid: 14566131
references.citation: Surgery. 2010 Aug;148(2):263-70
references.pmid: 20466401
references.citation: Crit Care Med. 2009 Nov;37(11):2946-52
references.pmid: 19770732
references.citation: Am Surg. 2007 Mar;73(3):249-52
references.pmid: 17375780
references.citation: Shock. 2005 Jun;23(6):571-5
references.pmid: 15897812
references.citation: Crit Care. 2006;10(2):R51
references.pmid: 16569255
references.citation: Acta Clin Belg. 2007;62 Suppl 1:225-32
references.pmid: 17469725
references.citation: J Surg Res. 2008 Jan;144(1):102-6
references.pmid: 17764694
references.citation: Acta Chir Belg. 2008 Mar-Apr;108(2):212-8
references.pmid: 18557146
references.citation: Shock. 2010 Nov;34(5):525-34
references.pmid: 20823698
references.citation: Intensive Care Med. 2006 Nov;32(11):1722-32
references.pmid: 16967294
references.citation: J Trauma. 2010 Mar;68(3):682-9
references.pmid: 20220423
references.citation: Shock. 2002 Oct;18(4):316-21
references.pmid: 12392274
references.citation: Shock. 2004 Nov;22(5):467-71
references.pmid: 15489640
references.citation: Shock. 2005 Aug;24(2):153-8
references.pmid: 16044086
references.citation: J Pediatr Surg. 2002 Feb;37(2):214-8
references.pmid: 11819201
references.citation: World J Surg. 2009 Jun;33(6):1134-41
references.pmid: 19343417
references.citation: Int J Pancreatol. 1991 Nov-Dec;10 (3-4):229-36
references.pmid: 1724008
references.citation: J Trauma. 2009 Apr;66(4):1118-24
references.pmid: 19359923
references.citation: J Trauma. 2009 Mar;66(3):713-9
references.pmid: 19276743