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2012, Number 4

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Med Crit 2012; 26 (4)

2nd place Winner to Prize «Dr. Mario Shapiro»
Evaluation of the effects of increased intra-abdominal pressure (IAP) on intracranial pressure (ICP), brain tissue oxygen pressure (PBTO2) and jugular bulb saturation (SJVO2) in a norm

Martínez MJJ, Poblano MM, Carmona SJA, Tendillo F, Jiménez F, Deloya TE, Lomelí TJM, Torrez LL

Language: Spanish
References: 17
Page: 215-225
PDF size: 123.66 Kb.


ABSTRACT

Introduction: There are reports of decreased brain perfusion pressure related to Intra-abdominal hypertension syndrome. This protocol evaluates the impact of increased abdominal pressure in brain perfusion and oxygenation.
Objectives: To evaluate the effects of increased intra-abdominal Pressure (IAP) on intracranial pressure (ICP), Brain tissue oxygen pressure (PbtO2) and saturation of jugular bulb (SjvO2) in normovolemic porcine model.
Methods: 3 porcine models were tested, in which we induced increase in abdominal pressure at different levels; there were performed measurements of intracranial pressure (ICP), brain tissue Oxygen pressure (PbtO2) and jugular bulb saturation (SjvO2) in each level of Intra-abdominal pressure. Subgroups were analyzed according to the level of intra-abdominal pressure and we made analysis of variance (ANOVA) considering significant a p value ‹ 0.05.
Results: The trend in the increase of ICP and the fall of PbtO2 and SjO2 is constant when Intra-abdominal pressure reaches 25 mmHg (p ‹ 0.5).
Conclusions: In a porcine model with normal brain, ICP increased significantly from 20 mmHg IAP, an opposite behavior occurred with the PbtO2 and SjvO2.


REFERENCES

  1. Aanerud J, et al. Brain energy metabolism and blood flow differences in healthy aging. Journal of Cerebral Blood Flow & Metabolism 2012:1-11.

  2. Yoshiaki Itoh, Norihiro Suzuki. Control of brain capillary blood flow. Journal of Cerebral Blood Flow & Metabolism 2012: 1-10.

  3. Gibbs EL, Lennox WG, Nims LF. Arterial and cerebral venous blood. Arterial-venous differences in man. J Biol Chem 1972;144:325-32.

  4. Feldman Z, Robertson CS. Monitoring of cerebral hemodynamics with jugular bulb catheters. Crit Care Clin 1997;13:51-77.

  5. Macmillan CSA, Andrews PJD. Cerebrovenous oxygen saturation monitoring: practical considerations and clinical relevance. Intensive Care Med 2000;26:1028-103.

  6. Gupta AK, Hutchinson PJ, Al-Rawi P. Measuring brain tissue oxygenation compared with jugular venous oxygen saturation for monitoring cerebral oxygenation after traumatic brain injury. Anesth Analg 1999;88:549-53.

  7. Goetting MG, Preston G. Jugular bulb catheterization: Experience with 123 patients. Crit Care Med 1999;18:1220-3.

  8. Ross N, Enyon CA. Intracranial pressure monitoring. Current Anaesthesia and Critical Care 2005;16:255–61.

  9. Tran Dihn A. Pression tissulaire ce´ re´ brale en oxyge`ne : pour quoi faire et pour qui? Annales Franc¸aises d’Anesthe´ sie et de Re´animation 2012;1(1):13.

  10. Results from International Conference of Experts on Intra-Abdominal Hypertension and Abdominal Compartment Syndrome. I. Definitions. Intensive Care Medicine 2006;32:1722-73.

  11. Results from International Conference of Experts on Intra-Abdominal Hypertension and Abdominal Compartment Syndrome. II. Recommendations. Intensive Care Medicine 2006;33:951-62.

  12. Reuter DA, et al. Usefulness of left ventricular stroke volume variation to assess fluid responsiveness in patients with reduced cardiac function. Crit Care Med 2003;31:1300-404.

  13. Reintam A, Parm P, Kitus R, Kern H, Starkopf J. Primary and secondary intra-abdominal hypertension-different impact on ICU outcome. Inten Care Med 2008;34:1624-31.

  14. Marik PE, Cavallazzi R, Vasu T, Hirani A. Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients. A systematic review of the literature. Crit Care Med 2009;37:2642-7.

  15. Augusto J, Teboul J, Radermarcher P, Asfar P. Interpretation of blood pressure signal: physiological bases, clinical relevance, and objectives during shock states. Inten Care Med 2011;37:411-9.

  16. Muller L, Louart G, Bousquet P, Candela D, Zoric L. The Influence of the airway driving pressure on pulsed pressure variation as a predictor of fluid responsiveness. Inten Care Med 2010;36:496-503.

  17. Deeren DH, et al. Correlation between intra-abdominal and intracranial pressure in nontraumatic brain injury. Intensive Care Med 2005;31:1577–81.




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