Document Detail


Splanchnic vasoregulation after major abdominal surgery in pigs.
MedLine Citation:
PMID:  20383500     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Unrecognized reduction of blood supply to intestinal organs is associated with significant postoperative morbidity in abdominal surgery. The aim of this study was to determine whether--in the absence of hypovolemia--intestinal hypoperfusion as a result of blood flow redistribution occurs after abdominal surgery.
METHODS: Standardized operative trauma was induced in 14 healthy pigs. Systemic, regional, and local blood flow, intestinal and gastric intraluminal-to-end-tidal pCO(2) gradients representing mucosal perfusion, and oxygen transport variables were measured for 10 postoperative hours. Normovolemia was maintained using continuous infusion of Ringer's lactate and additional boluses of colloids in response to blood pressure, pulmonary wedge pressure, and urinary output.
RESULTS: Postoperative blood flow was significantly increased in the celiac trunk (76% increase [percentage of baseline flow], p = 0.003) and the hepatic (136% increase, p = 0.002) and splenic (36% increase, p = 0.025) arteries. Blood flow was significantly decreased in the mesenteric artery (25% decrease, p = 0.007) and portal vein (13% decrease, p = 0.028). Carotid and renal artery blood flow remained unchanged.
CONCLUSIONS: Maintenance of normovolemia is insufficient to protect from intestinal hypoperfusion after abdominal surgery. Postoperative redistribution of cardiac output results in decreased intestinal and increased hepatic and splenic arterial blood flow.
Authors:
Lukas E Brügger; Guido Beldi; Mario Beck; Francesca Porta; Hendrik Bracht; Daniel Candinas; Jukka Takala; Stephan M Jakob
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  World journal of surgery     Volume:  34     ISSN:  1432-2323     ISO Abbreviation:  World J Surg     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-09     Completed Date:  2010-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2057-63     Citation Subset:  IM    
Affiliation:
Department of Visceral Surgery and Medicine, Bern University Hospital and University of Bern, 3010 Bern, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Volume
Cardiac Output
Digestive System Surgical Procedures*
Hemodynamics
Intestines / blood supply*,  physiopathology
Microcirculation
Postoperative Period
Regional Blood Flow
Splanchnic Circulation / physiology*
Swine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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