title: Mechanical Intestinal Obstruction in a Porcine Model: Effects of Intra-Abdominal Hypertension. A Preliminary Study.
abstract: BACKGROUND
  Mechanical intestinal obstruction is a disorder associated with intra-abdominal hypertension and abdominal compartment syndrome. As the large intestine intraluminal and intra-abdominal pressures are increased, so the patient's risk for intestinal ischaemia. Previous studies have focused on hypoperfusion and bacterial translocation without considering the concomitant effect of intra-abdominal hypertension. The objective of this study was to design and evaluate a mechanical intestinal obstruction model in pigs similar to the human pathophysiology.
  
  
  METHODS
  Fifteen pigs were divided into three groups: a control group (n = 5) and two groups of 5 pigs with intra-abdominal hypertension induced by mechanical intestinal obstruction. The intra-abdominal pressures of 20 mmHg were maintained for 2 and 5 hours respectively. Hemodynamic, respiratory and gastric intramucosal pH values, as well as blood tests were recorded every 30 min.
  
  
  RESULTS
  Significant differences between the control and mechanical intestinal obstruction groups were noted. The mean arterial pressure, cardiac index, dynamic pulmonary compliance and abdominal perfusion pressure decreased. The systemic vascular resistance index, central venous pressure, pulse pressure variation, airway resistance and lactate increased within 2 hours from starting intra-abdominal hypertension (p<0.05). In addition, we observed increased values for the peak and plateau airway pressures, and low values of gastric intramucosal pH in the mechanical intestinal obstruction groups that were significant after 3 hours.
  
  
  CONCLUSIONS
  The mechanical intestinal obstruction model appears to adequately simulate the pathophysiology of intestinal obstruction that occurs in humans. Monitoring abdominal perfusion pressure, dynamic pulmonary compliance, gastric intramucosal pH and lactate values may provide insight in predicting the effects on endorgan function in patients with mechanical intestinal obstruction.
authors: Laparoscopy Department, Jesús Usón Minimally Invasive Surgery Centre (JUMISC), Cáceres, Spain.
authors: L
authors: L
authors: Correa-Martín
authors: Department of Anatomy and Comparative Pathology, Veterinary Faculty, University of Murcia, Murcia, Spain.
authors: E
authors: E
authors: Párraga
authors: Laparoscopy Department, Jesús Usón Minimally Invasive Surgery Centre (JUMISC), Cáceres, Spain.
authors: F M
authors: FM
authors: Sánchez-Margallo
authors: Department of Anatomy and Comparative Pathology, Veterinary Faculty, University of Murcia, Murcia, Spain.
authors: R
authors: R
authors: Latorre
authors: Department of Anatomy and Comparative Pathology, Veterinary Faculty, University of Murcia, Murcia, Spain.
authors: O
authors: O
authors: López-Albors
authors: Critical Care Unit, Edendale Hospital, Pietermaritzburg, South Africa, and Department of Anaesthetics and Critical Care, Perioperative Research Group, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors: R
authors: R
authors: Wise
authors: Medical and surgical ICU and high care Burn Unit, Ziekenhuis Netwerk Antwerpen, Antwerpen, Belgium.
authors: M L N G
authors: ML
authors: Malbrain
authors: Department of General Surgery, Virgen de la Arrixaca General University Hospital, Murcia, Spain.
authors: G
authors: G
authors: Castellanos
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D006439:Hemodynamics; D007415:Intestinal Obstruction / Q000150:complications* / Q000503:physiopathology; D059325:Intra-Abdominal Hypertension / Q000150:complications*; D012119:Respiration; D013552:Swine