Effect of abdominal distension on central and regional hemodynamics in neonatal lambs

Sally A. Masey, Raymond C Koehler, James R. Buck, James M. Pepple, Mark C. Rogers, Richard J. Traystman

Research output: Contribution to journalArticle

Abstract

Elevations of intraabdominal pressure (IAP) can occur during surgical repair of gastroschisis and omphalocele and lead to ischemia of abdominal organs. We examined the effect of elevated IAP on central hemodynamics and regional abdominal organ blood flow, measured by radiolabeled microspheres, in 11 pentobarbital-anesthe-tized neonatal lambs. Stepwise increases in IAP were obtained by inflating a large bag placed intraperitoneally with air to pressures of 15, 20, and 25 mm Hg. Measurements were made at 30 min of elevated IAP and 30 min after deflating the bag. Mean aortic pressure was not significantly altered at an IAP of 15 mm Hg (78 ± 4 mm Hg) (±SE) or 20 mm Hg (76 ± 4 mm Hg) compared to baseline (81 ± 4 mm Hg), but was decreased at the highest IAP (68 ± 5 mm Hg). Stepwise decreases in blood flow to all abdominal organs, except adrenal gland, occurred with elevated IAP, and blood flows to these organs (except spleen) returned to or above baseline on bag deflation. At IAP of 15, 20, and 25 mm Hg, cardiac output was reduced by 14, 21, and 35%, respectively. Similar percent reductions of renal blood flow occurred. However, regional gastrointestinal blood flow decreased by a greater extent (35, 50, and 54% at each respective IAP). Hepatic arterial blood flow more than doubled at each IAP, but this was not sufficient to maintain total liver blood flow, or presumably total oxygen delivery to liver. The marked curtailment of splanchnic blood flow suggests that prolonged periods of elevated IAP at or above 15 mm Hg should be avoided in repair of gastroschisis and omphalocele or in other situations that can produce profound abdominal distension, such as swelling from liver transplantation or gaseous distension.

Original languageEnglish (US)
Pages (from-to)1244-1249
Number of pages6
JournalPediatric Research
Volume19
Issue number12
StatePublished - 1985

Fingerprint

Hemodynamics
Pressure
Gastroschisis
Umbilical Hernia
Liver
Air Pressure
Viscera
Renal Circulation
Regional Blood Flow
Pentobarbital
Adrenal Glands
Microspheres
Cardiac Output
Liver Transplantation
Arterial Pressure
Spleen
Ischemia
Oxygen
Blood Pressure

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Masey, S. A., Koehler, R. C., Buck, J. R., Pepple, J. M., Rogers, M. C., & Traystman, R. J. (1985). Effect of abdominal distension on central and regional hemodynamics in neonatal lambs. Pediatric Research, 19(12), 1244-1249.

Effect of abdominal distension on central and regional hemodynamics in neonatal lambs. / Masey, Sally A.; Koehler, Raymond C; Buck, James R.; Pepple, James M.; Rogers, Mark C.; Traystman, Richard J.

In: Pediatric Research, Vol. 19, No. 12, 1985, p. 1244-1249.

Research output: Contribution to journalArticle

Masey, SA, Koehler, RC, Buck, JR, Pepple, JM, Rogers, MC & Traystman, RJ 1985, 'Effect of abdominal distension on central and regional hemodynamics in neonatal lambs', Pediatric Research, vol. 19, no. 12, pp. 1244-1249.
Masey SA, Koehler RC, Buck JR, Pepple JM, Rogers MC, Traystman RJ. Effect of abdominal distension on central and regional hemodynamics in neonatal lambs. Pediatric Research. 1985;19(12):1244-1249.
Masey, Sally A. ; Koehler, Raymond C ; Buck, James R. ; Pepple, James M. ; Rogers, Mark C. ; Traystman, Richard J. / Effect of abdominal distension on central and regional hemodynamics in neonatal lambs. In: Pediatric Research. 1985 ; Vol. 19, No. 12. pp. 1244-1249.
@article{5b3432f991744437a5190304d1b7fd0f,
title = "Effect of abdominal distension on central and regional hemodynamics in neonatal lambs",
abstract = "Elevations of intraabdominal pressure (IAP) can occur during surgical repair of gastroschisis and omphalocele and lead to ischemia of abdominal organs. We examined the effect of elevated IAP on central hemodynamics and regional abdominal organ blood flow, measured by radiolabeled microspheres, in 11 pentobarbital-anesthe-tized neonatal lambs. Stepwise increases in IAP were obtained by inflating a large bag placed intraperitoneally with air to pressures of 15, 20, and 25 mm Hg. Measurements were made at 30 min of elevated IAP and 30 min after deflating the bag. Mean aortic pressure was not significantly altered at an IAP of 15 mm Hg (78 ± 4 mm Hg) (±SE) or 20 mm Hg (76 ± 4 mm Hg) compared to baseline (81 ± 4 mm Hg), but was decreased at the highest IAP (68 ± 5 mm Hg). Stepwise decreases in blood flow to all abdominal organs, except adrenal gland, occurred with elevated IAP, and blood flows to these organs (except spleen) returned to or above baseline on bag deflation. At IAP of 15, 20, and 25 mm Hg, cardiac output was reduced by 14, 21, and 35{\%}, respectively. Similar percent reductions of renal blood flow occurred. However, regional gastrointestinal blood flow decreased by a greater extent (35, 50, and 54{\%} at each respective IAP). Hepatic arterial blood flow more than doubled at each IAP, but this was not sufficient to maintain total liver blood flow, or presumably total oxygen delivery to liver. The marked curtailment of splanchnic blood flow suggests that prolonged periods of elevated IAP at or above 15 mm Hg should be avoided in repair of gastroschisis and omphalocele or in other situations that can produce profound abdominal distension, such as swelling from liver transplantation or gaseous distension.",
author = "Masey, {Sally A.} and Koehler, {Raymond C} and Buck, {James R.} and Pepple, {James M.} and Rogers, {Mark C.} and Traystman, {Richard J.}",
year = "1985",
language = "English (US)",
volume = "19",
pages = "1244--1249",
journal = "Pediatric Research",
issn = "0031-3998",
publisher = "Lippincott Williams and Wilkins",
number = "12",

}

TY - JOUR

T1 - Effect of abdominal distension on central and regional hemodynamics in neonatal lambs

AU - Masey, Sally A.

AU - Koehler, Raymond C

AU - Buck, James R.

AU - Pepple, James M.

AU - Rogers, Mark C.

AU - Traystman, Richard J.

PY - 1985

Y1 - 1985

N2 - Elevations of intraabdominal pressure (IAP) can occur during surgical repair of gastroschisis and omphalocele and lead to ischemia of abdominal organs. We examined the effect of elevated IAP on central hemodynamics and regional abdominal organ blood flow, measured by radiolabeled microspheres, in 11 pentobarbital-anesthe-tized neonatal lambs. Stepwise increases in IAP were obtained by inflating a large bag placed intraperitoneally with air to pressures of 15, 20, and 25 mm Hg. Measurements were made at 30 min of elevated IAP and 30 min after deflating the bag. Mean aortic pressure was not significantly altered at an IAP of 15 mm Hg (78 ± 4 mm Hg) (±SE) or 20 mm Hg (76 ± 4 mm Hg) compared to baseline (81 ± 4 mm Hg), but was decreased at the highest IAP (68 ± 5 mm Hg). Stepwise decreases in blood flow to all abdominal organs, except adrenal gland, occurred with elevated IAP, and blood flows to these organs (except spleen) returned to or above baseline on bag deflation. At IAP of 15, 20, and 25 mm Hg, cardiac output was reduced by 14, 21, and 35%, respectively. Similar percent reductions of renal blood flow occurred. However, regional gastrointestinal blood flow decreased by a greater extent (35, 50, and 54% at each respective IAP). Hepatic arterial blood flow more than doubled at each IAP, but this was not sufficient to maintain total liver blood flow, or presumably total oxygen delivery to liver. The marked curtailment of splanchnic blood flow suggests that prolonged periods of elevated IAP at or above 15 mm Hg should be avoided in repair of gastroschisis and omphalocele or in other situations that can produce profound abdominal distension, such as swelling from liver transplantation or gaseous distension.

AB - Elevations of intraabdominal pressure (IAP) can occur during surgical repair of gastroschisis and omphalocele and lead to ischemia of abdominal organs. We examined the effect of elevated IAP on central hemodynamics and regional abdominal organ blood flow, measured by radiolabeled microspheres, in 11 pentobarbital-anesthe-tized neonatal lambs. Stepwise increases in IAP were obtained by inflating a large bag placed intraperitoneally with air to pressures of 15, 20, and 25 mm Hg. Measurements were made at 30 min of elevated IAP and 30 min after deflating the bag. Mean aortic pressure was not significantly altered at an IAP of 15 mm Hg (78 ± 4 mm Hg) (±SE) or 20 mm Hg (76 ± 4 mm Hg) compared to baseline (81 ± 4 mm Hg), but was decreased at the highest IAP (68 ± 5 mm Hg). Stepwise decreases in blood flow to all abdominal organs, except adrenal gland, occurred with elevated IAP, and blood flows to these organs (except spleen) returned to or above baseline on bag deflation. At IAP of 15, 20, and 25 mm Hg, cardiac output was reduced by 14, 21, and 35%, respectively. Similar percent reductions of renal blood flow occurred. However, regional gastrointestinal blood flow decreased by a greater extent (35, 50, and 54% at each respective IAP). Hepatic arterial blood flow more than doubled at each IAP, but this was not sufficient to maintain total liver blood flow, or presumably total oxygen delivery to liver. The marked curtailment of splanchnic blood flow suggests that prolonged periods of elevated IAP at or above 15 mm Hg should be avoided in repair of gastroschisis and omphalocele or in other situations that can produce profound abdominal distension, such as swelling from liver transplantation or gaseous distension.

UR - http://www.scopus.com/inward/record.url?scp=0022355575&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0022355575&partnerID=8YFLogxK

M3 - Article

C2 - 4080441

AN - SCOPUS:0022355575

VL - 19

SP - 1244

EP - 1249

JO - Pediatric Research

JF - Pediatric Research

SN - 0031-3998

IS - 12

ER -