PP 122. Effect of Splanchnic Circulation on an Intestinal Obstruction Model

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L. Correa-Martín, L. Hernández Hurtado, G. Castellanos, M. García-Lindo, I. Días-Güemes Martín-Portugués, F. Sánchez-Margallo

16:36 - 16:42h at Lanchid Room

Categories: Intensive Care in Surgery, Poster Session

Session: Poster II (P4) - Varia

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Background
Intestinal obstruction is one of the main causes for increased intraabdominal pressure (IAP) in humans. Tonometry is the usual method to determine the degree of ischemia in the gastrointestinal tract. To assess the prognostic value of gastric air tonometry as a predictor of inadequate splanchnic perfusion on a porcine model of intestinal obstruction.

Material and Methods
Animals were divided in two groups of 5 animals each according to IAP constituting a control group and a group with increased IAP up to 30 mmHg. In the latter, pressure was maintained for 3 hours. The acidity of the gastric mucosa was determined by measuring the intramucosal gastric pH (pHim) and PgCO2. Using IAP and mean arterial pressure (MAP) values we indirectly obtained the abdominal perfusion pressure (APP) with the following formula: APP=MAP– IAP. The measurements were registered at eight different times throughout the study.

Result
In 30 mmHg group there is a time progressive decrease of pHim, with statistically significant differences observed between groups 30 min after increased IAP. The values of PgCO2 were increased. In this parameter, significant differences were observed between groups from the start of increased IAP. There is a time progressive decrease of APP, with statistically significant differences being observed between groups 60 min after increased IAP.

Conclusion
The experimental model used on this study allows for the simulation of the pathophysiological changes occurring in human patients with IAP. Moreover, tonometry allows for the early detection of gastric mucosal sensitivity to splanchnic hypoperfusion due to IAP.