Limits...
The effect of intra-abdominal hypertension incorporating severe acute pancreatitis in a porcine model.

Ke L, Tong ZH, Ni HB, Ding WW, Sun JK, Li WQ, Li N, Li JS - PLoS ONE (2012)

Bottom Line: Cardiac output significantly decreased in the SAP+IAH animals compared with other groups.Furthermore, AST, creatinine, SUN and lactate showed similar increasing tendency paralleled with profoundly decrease in S(v)O(2).However, few differences were found between the two SAP+IAH groups with different levels of IAP.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Jinling Hospital, Nanjing University, School of Medicine, Nanjing, China.

ABSTRACT

Introduction: Abdominal compartment syndrome (ACS) and intra abdominal hypertension(IAH) are common clinical findings in patients with severe acute pancreatitis(SAP). It is thought that an increased intra abdominal pressure(IAP) is associated with poor prognosis in SAP patients. But the detailed effect of IAH/ACS on different organ system is not clear. The aim of this study was to assess the effect of SAP combined with IAH on hemodynamics, systemic oxygenation, and organ damage in a 12 h lasting porcine model.

Measurements and methods: Following baseline registrations, a total of 30 animals were divided into 5 groups (6 animals in each group): SAP+IAP30 group, SAP+IAP20 group, SAP group, IAP30 group(sham-operated but without SAP) and sham-operated group. We used a N(2) pneumoperitoneum to induce different levels of IAH and retrograde intra-ductal infusion of sodium taurocholate to induce SAP. The investigation period was 12 h. Hemodynamic parameters (CO, HR, MAP, CVP), urine output, oxygenation parameters(e.g., S(v)O(2), PO(2), PaCO(2)), peak inspiratory pressure, as well as serum parameters (e.g., ALT, amylase, lactate, creatinine) were recorded. Histological examination of liver, intestine, pancreas, and lung was performed.

Main results: Cardiac output significantly decreased in the SAP+IAH animals compared with other groups. Furthermore, AST, creatinine, SUN and lactate showed similar increasing tendency paralleled with profoundly decrease in S(v)O(2). The histopathological analyses also revealed higher grade injury of liver, intestine, pancreas and lung in the SAP+IAH groups. However, few differences were found between the two SAP+IAH groups with different levels of IAP.

Conclusions: Our newly developed porcine SAP+IAH model demonstrated that there were remarkable effects on global hemodynamics, oxygenation and organ function in response to sustained IAH of 12 h combined with SAP. Moreover, our model should be helpful to study the mechanisms of IAH/ACS-induced exacerbation and to optimize the treatment strategies for counteracting the development of organ dysfunction.

Show MeSH

Related in: MedlinePlus

The comparisons of histopathology scores among five experimental groups (*Significant difference vs. sham group; # significant difference vs. IAP30 group; +significant difference vs.SAP group).
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3293917&req=5

pone-0033125-g003: The comparisons of histopathology scores among five experimental groups (*Significant difference vs. sham group; # significant difference vs. IAP30 group; +significant difference vs.SAP group).

Mentions: The histopathological results of the pancreas, liver, small bowel and lung are shown in Figure 3. Since the pathological presentations of SAP+IAP30 and SAP+IAP20 animals were similar, we only included typical graphs for both of these two groups. Histological analysis of pancreas tissue demonstrated severe necrosis in all SAP animals and in some of which no pancreatic issue could be seen (Figure 4A). The specimen of IAP30 animals presented degenerative changes with very mild necrosis (Figure 4B), while the sham-operated animals only presented mild edema and inflammation(Figure 4C)


The effect of intra-abdominal hypertension incorporating severe acute pancreatitis in a porcine model.

Ke L, Tong ZH, Ni HB, Ding WW, Sun JK, Li WQ, Li N, Li JS - PLoS ONE (2012)

The comparisons of histopathology scores among five experimental groups (*Significant difference vs. sham group; # significant difference vs. IAP30 group; +significant difference vs.SAP group).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3293917&req=5

pone-0033125-g003: The comparisons of histopathology scores among five experimental groups (*Significant difference vs. sham group; # significant difference vs. IAP30 group; +significant difference vs.SAP group).
Mentions: The histopathological results of the pancreas, liver, small bowel and lung are shown in Figure 3. Since the pathological presentations of SAP+IAP30 and SAP+IAP20 animals were similar, we only included typical graphs for both of these two groups. Histological analysis of pancreas tissue demonstrated severe necrosis in all SAP animals and in some of which no pancreatic issue could be seen (Figure 4A). The specimen of IAP30 animals presented degenerative changes with very mild necrosis (Figure 4B), while the sham-operated animals only presented mild edema and inflammation(Figure 4C)

Bottom Line: Cardiac output significantly decreased in the SAP+IAH animals compared with other groups.Furthermore, AST, creatinine, SUN and lactate showed similar increasing tendency paralleled with profoundly decrease in S(v)O(2).However, few differences were found between the two SAP+IAH groups with different levels of IAP.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Jinling Hospital, Nanjing University, School of Medicine, Nanjing, China.

ABSTRACT

Introduction: Abdominal compartment syndrome (ACS) and intra abdominal hypertension(IAH) are common clinical findings in patients with severe acute pancreatitis(SAP). It is thought that an increased intra abdominal pressure(IAP) is associated with poor prognosis in SAP patients. But the detailed effect of IAH/ACS on different organ system is not clear. The aim of this study was to assess the effect of SAP combined with IAH on hemodynamics, systemic oxygenation, and organ damage in a 12 h lasting porcine model.

Measurements and methods: Following baseline registrations, a total of 30 animals were divided into 5 groups (6 animals in each group): SAP+IAP30 group, SAP+IAP20 group, SAP group, IAP30 group(sham-operated but without SAP) and sham-operated group. We used a N(2) pneumoperitoneum to induce different levels of IAH and retrograde intra-ductal infusion of sodium taurocholate to induce SAP. The investigation period was 12 h. Hemodynamic parameters (CO, HR, MAP, CVP), urine output, oxygenation parameters(e.g., S(v)O(2), PO(2), PaCO(2)), peak inspiratory pressure, as well as serum parameters (e.g., ALT, amylase, lactate, creatinine) were recorded. Histological examination of liver, intestine, pancreas, and lung was performed.

Main results: Cardiac output significantly decreased in the SAP+IAH animals compared with other groups. Furthermore, AST, creatinine, SUN and lactate showed similar increasing tendency paralleled with profoundly decrease in S(v)O(2). The histopathological analyses also revealed higher grade injury of liver, intestine, pancreas and lung in the SAP+IAH groups. However, few differences were found between the two SAP+IAH groups with different levels of IAP.

Conclusions: Our newly developed porcine SAP+IAH model demonstrated that there were remarkable effects on global hemodynamics, oxygenation and organ function in response to sustained IAH of 12 h combined with SAP. Moreover, our model should be helpful to study the mechanisms of IAH/ACS-induced exacerbation and to optimize the treatment strategies for counteracting the development of organ dysfunction.

Show MeSH
Related in: MedlinePlus