Evaluating the effects of immediate application of negative  pressure therapy after decompression from abdominal  compartment syndrome in an experimental porcine model

Evaluating the effects of immediate application of negative pressure therapy after decompression from abdominal compartment syndrome in an experimental porcine model

  • نوع فایل : کتاب
  • زبان : انگلیسی
  • مؤلف : S. K. Shah • F. Jimenez • P. A. Walker • H. Xue • T. D. Feeley • K. S. Uray • K. C. Norbury • R. H. Stewart • G. A. Laine • C. S. Cox Jr
  • چاپ و سال / کشور: 2011

Description

Purpose 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 intraabdominal 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 r
Eur J Trauma Emerg Surg DOI 10.1007/s00068-011-0136-z Received: 11 February 2011 / Accepted: 28 June 2011
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