Hormonal Changes Related to Reduced Renal Blood Flow and Low Urine Output Under Prolonged Increased Intra-abdominal Pressure in Pigs

Gudmundsson, F. F.; Gíslason, Hjörtur; Myking, Ole L.; Viste, Asgaut; Grong, Ketil; Svanes, Knut

doi:10.1080/110241502320127801

Cited by 19 publications

(26 citation statements)

References 15 publications

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“…dominal pressure (IAP) is associated with reduced blood flow in intraabdominal organs, including the kidneys [3,4,9,10,12]. If this condition persists for hours or days, it may result in organ tissue necrosis and multiorgan failure.…”

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confidence: 99%

Role of angiotensin II under prolonged increased intraabdominal pressure (IAP) in pigs

et al. 2003

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mentioning

confidence: 99%

Role of angiotensin II under prolonged increased intraabdominal pressure (IAP) in pigs

et al. 2003

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“…Additionally, it is likely that in the head-up posture cardiac preload decreases and might reduce cardiac output. Apparently, posture and the extent of the IAP, regardless of the insufflation gas used, affect catecholamine and vasopressin levels when capacitance vessels are compressed but not collapsed (IAP < 20 mm Hg) [3,15,16]. The question of why norepinephrine decreased under the same conditions in our trial remains to be answered.…”

Section: Discussionmentioning

confidence: 71%

Effects of Animal Positioning on Catecholamine and Vasopressin Levels in Pigs Undergoing Laparoscopy

et al. 2011

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Background: The aim of this study was to determine the influence of different therapeutic interventions and positions on catecholamine and vasopressin levels in the pneumoperitoneum (PN) in a porcine model. Methods: In 43 pigs, a 14-mm-Hg PN was established and plasma concentrations of epinephrine, norepinephrine and vasopressin were measured in head-up, supine and head-down positions. Additionally, the effects of the following changes were studied: (1) increase in intrathoracic blood volume (ITBV) by means of hydroxyethyl starch infusion; (2) vasodilatation induced by sodium nitroprusside, or (3) selective sympathicolysis induced by esmolol. Again, catecholamines (ELISA) and vasopressin (RIA) were determined. Results: After PN, epinephrine levels did not significantly increase in the head-up position (p = 0.075) and remained also unchanged in the supine or head-down position. Plasma norepinephrine statistically significantly decreased in the head-up position (p = 0.046). Vasopressin concentrations remained unaltered. After increased ITBV, neither catecholamine nor vasopressin concentrations changed in any body position. Application of sodium nitroprusside or esmolol caused no changes. Conclusion: Changes in endogenous catecholamine levels safely prevent cardiocirculatory instability in small pigs. Volume substitution might reduce endocrine responses to PN in the head-up position.

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“…Organ compression may also result in alterations in the renin-angiotensin-aldosterone mechanism [11,52]. More commonly, however, increased SVR occurs as compensation for the reduced venous return and falling stroke volume outlined above.…”

Section: Effect Of Intra-abdominal Hypertension On Afterloadmentioning

confidence: 99%

“…Cephalad movement of the diaphragm leads to direct compression on the heart with reduction of the right and left ventricle end-diastolic volumes. Secondly, the cardiac preload decreases due to decreased venous return from the abdomen and the systemic afterload is increased due to direct compression of vascular beds and activation of the renin-angiotensin-aldosteron pathway [11]. This leads to decreased cardiac output (CO).…”

Section: Cardiovascular Effects Associated With Intra-abdominal Hypermentioning

confidence: 99%

What every ICU clinician needs to know about the cardiovascular effects caused by abdominal hypertension

Malbrain

Waele²,

Keulenaer³

2015

Anaesthesiol Intensive Ther

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The effects of increased intra-abdominal pressure (IAP) on cardiovascular function are well recognized and include a combined negative effect on preload, afterload and contractility. The aim of this review is to summarize the current knowledge on this topic. The presence of intra-abdominal hypertension (IAH) erroneously increases barometric filling pressures like central venous (CVP) and pulmonary artery occlusion pressure (PAOP) (since these are zeroed against atmospheric pressure). Transmural filling pressures (calculated by subtracting the pleural pressure from the end-expiratory CVP value) may better reflect the true preload status but are difficult to obtain at the bedside. Alternatively, since pleural pressures are seldom measured, transmural CVP can also be estimated by subtracting half of the IAP from the end-expiratory CVP value, since abdominothoracic transmission is on average 50%. Volumetric preload indicators, such as global and right ventricular end-diastolic volumes or the left ventricular end-diastolic area, also correlate better with true preload. When using functional hemodynamic monitoring parameters like stroke volume variation (SVV) or pulse pressure variation (PPV) one must bear in mind that increased IAP will increase these values (via a concomitant increase in intrathoracic pressure). The passive leg raising test may be a false negative in IAH. Calculation of the abdominal perfusion pressure (as mean arterial pressure minus IAP) has been shown to be a better resuscitation endpoint than IAP alone. Finally, it is re-assuring that transpulmonary thermodilution techniques have been validated in the setting of IAH and abdominal compartment syndrome. In conclusion, the clinician must be aware of the different effects of IAH on cardiovascular function in order to assess the volume status accurately and to optimize hemodynamic performance.

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Hormonal Changes Related to Reduced Renal Blood Flow and Low Urine Output Under Prolonged Increased Intra-abdominal Pressure in Pigs

Cited by 19 publications

References 15 publications

Role of angiotensin II under prolonged increased intraabdominal pressure (IAP) in pigs

Role of angiotensin II under prolonged increased intraabdominal pressure (IAP) in pigs

Effects of Animal Positioning on Catecholamine and Vasopressin Levels in Pigs Undergoing Laparoscopy

What every ICU clinician needs to know about the cardiovascular effects caused by abdominal hypertension

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