Intrabladder pressure as predictor of intra-abdominal pressure in horses


Autoři: Vanessa B. de Paula aff001;  Paulo A. Canola aff002;  Gabriela G. Rivera aff001;  Dárcio Z. Filho aff001;  Gabriel P. D. Amaral aff003;  Guilherme C. Ferraz aff004;  Antônio S. Ferraudo aff005;  Júlio C. Canola aff002
Působiště autorů: Graduate Program in Veterinary Surgery, São Paulo State University (Unesp), School of Agricultural and Veterinarian Sciences, Jaboticabal, SP, Brazil aff001;  Department of Veterinary Medicine and Surgery, São Paulo State University (Unesp), School of Agricultural and Veterinarian Sciences, Jaboticabal, SP, Brazil aff002;  Residency Program in Large Animal Surgery, São Paulo State University (Unesp), School of Agricultural and Veterinarian Sciences, Jaboticabal, SP, Brazil aff003;  Department of Animal Morphology and Physiology, São Paulo State University (Unesp), School of Agricultural and Veterinarian Sciences, Jaboticabal, SP, Brazil aff004;  Department of Exact Sciences, São Paulo State University (Unesp), School of Agricultural and Veterinarian Sciences, Jaboticabal, SP, Brazil aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223705

Souhrn

Objectives

To investigate effects of postural changes and bladder distention on intrabladder pressure whilst estimating intra-abdominal pressure in horses.

Design

Two-year cohort study. Patients admitted for elective surgical procedures unrelated to gastrointestinal or genitourinary tract.

Setting

School of Agricultural and Veterinarian Sciences, Jaboticabal, SP, Brazil.

Animals

20 adult horses, 11 males (stallions and geldings) and 9 females; between 3.5 and 12 years, weighing 350 to 500 kg.

Interventions

Intra-abdominal pressure was directly-recorded through abdominocentesis at the ventral midline with a fluid-filled system. Intrabladder pressure was obtained from a bladder catheter with the fluid-filled system zeroed at the level of the tuber ischia with patients in dorsal recumbency or pubic symphysis if in lateral recumbency.

Measurements and main results

Body position directly influenced intra-abdominal pressure. In dorsal recumbency, intra-abdominal pressure differed (p < 0.05) from intrabladder pressure at end-inspiration and end-expiration regardless of whether the bladder was empty or distended. There was no correlation nor association between the two pressures in this body position. In lateral recumbency a difference (p <0.05) between intra-abdominal pressure and intrabladder pressure was recorded at end-inspiration with the bladder distended with 25 ml, and at end-expiration for distension volumes of 25 ml and 50 ml. There was a strong correlation between both pressures for left and right lateral recumbency, regardless of the distension volume. Ordinary least product (OLP) regression analysis showed no fixed or proportional bias between both pressures for distension volume of 50 ml, at both end-inspiration and end-expiration.

Conclusions

Indirect assessment of equine intra-abdominal pressure cannot be made in dorsal recumbency. For that purpose, patients should be in left lateral recumbency with the bladder distended with 50 ml. Values can be recorded at end-inspiration or end-expiration.

Restriction

Occlusion of the catheter tip by the bladder wall when minimally distended.

Klíčová slova:

Bladder – Catheters – Digestive system procedures – Equines – Gastrointestinal tract – Horses – Regression analysis – Surgical and invasive medical procedures


Zdroje

1. Malbrain MLNG, Cheatham ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J, et al. Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. I. Definitions. Intensive Care Med [Internet]. 2006; 32(11):1722–32. doi: 10.1007/s00134-006-0349-5 16967294

2. Brosnahan MM, Holbrook TC, Gilliam LL, Ritchey JW, Confer AW. Intra-abdominal hypertension in two adult horses: Case Series. J Vet Emerg Crit Care. 2009;19(2):174–80. http://doi.org/10.1111/j.1476-4431.2009.00400.x.

3. Kron IL, Harman PK, Nolan SP. The measurement of intra-abdominal pressure as a criterion for abdominal re-exploration. Ann Surg [Internet]. Lippincott, Williams, and Wilkins; 1984; 199(1):28–30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/6691728 doi: 10.1097/00000658-198401000-00005 6691728

4. Malbrain MLNG. Different techniques to measure intra-abdominal pressure (IAP): time for a critical re-appraisal. Intensive Care Med [Internet]. 2004; 30(3):357–71. doi: 10.1007/s00134-003-2107-2 14730376

5. De Keulenaer BL, De Waele JJ, Powell B, Malbrain MLNG. What is normal intra-abdominal pressure and how is it affected by positioning, body mass and positive end-expiratory pressure? Intensive Care Med [Internet]. 2009; 35(6):969–76. doi: 10.1007/s00134-009-1445-0 19242675

6. Hurcombe SDA, Scott VHL. Direct intra-abdominal pressures and abdominal perfusion pressures in unsedated normal horses. J Vet Emerg Crit Care (San Antonio) [Internet]. 2012; 22(4):441–6. http://doi.org/10.1111/j.1476-4431.2012.00774.x.

7. Obeid F, Saba A, Fath J, Guslits B, Chung R, Sorensen V, et al. Increases in intra-abdominal pressure affect pulmonary compliance. Arch Surg [Internet]. 1995; 130(5):544–7; discussion 547–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7748095 doi: 10.1001/archsurg.1995.01430050094016 7748095

8. Turnbull D, Webber S, Hamnegard CH, Mills GH. Intra-abdominal pressure measurement: validation of intragastric pressure as a measure of intra-abdominal pressure. Br J Anaesth [Internet]. 2007; 98(5):628–34. doi: 10.1093/bja/aem060 17456490

9. Malbrain ML, Deeren DH. Effect of bladder volume on measured intravesical pressure: a prospective cohort study. Crit Care [Internet]. 2006; 10(4):R98. doi: 10.1186/cc4962 16934130

10. Cheatham ML. Abdominal Compartment Syndrome: pathophysiology and definitions. Scand J Trauma Resusc Emerg Med [Internet]. BioMed Central; 2009; 17(1):10. http://doi.org/10.1186/1757-7241-17-10

11. Monteiro B, Pereira T, Fraga GP. SÍNDROME COMPARTIMENTAL ABDOMINAL [Internet]. 2013. Available from: http://www.cirurgiaunisa.com.br/assets/proaci—síndrome-compartimental.pdf

12. De Waele J, Pletinckx P, Blot S, Hoste E. Saline volume in transvesical intra-abdominal pressure measurement: enough is enough. Intensive Care Med [Internet]. 2006; 32(3):455–9. Available from: doi: 10.1007/s00134-005-0062-9 16477411

13. Canola PA, Perotta JH, Penteado DDM, Canola JC et al. Alternative Intrabladder Manometry Technique for the Indirect Measurement of Intra-abdominal Pressure in Horses. 2012; http://doi.org/10.1016/j.jevs.2011.08.017.

14. De Laet I, Hoste E, De Waele JJ. Transvesical intra-abdominal pressure measurement using minimal instillation volumes: how low can we go? Intensive Care Med [Internet]. 2008; 34(4):746–50. doi: 10.1007/s00134-007-0985-4 18227998

15. Bersani AL, Gomes JO, Braga ILS, Guimarães HP, Lopes RD. Síndrome compartimental abdominal. Rev Bras Clínica Médica [Internet]. 2009; 7:313–21. Available from: http://files.bvs.br/upload/S/1679-1010/2009/v7n5/a008.pdf

16. Canola PA, Perotta JH, Laskoski LM, Escobar A et al. Effect of passive pneumoperitoneum on oesophageal pressure, cardiovascular parameters and blood gas analysis in horses. Equine Vet J [Internet]. American Medical Association (AMA); 2011; 43(4):446–50. Available from: doi: 10.1111/j.2042-3306.2010.00304.x 21496077

17. Dechant JE, Nieto JE. Comparison of Techniques For Measurement of Intra-Abdominal Pressure In Horses. In: WSACS—the Abdominal Compartment Society, editor. 14th American College of World Society of the Abdominal Compartment Syndrome; 2008. Available from: http://www.wsacs.org/

18. Munsterman AS, Hanson RR. Comparison of direct and indirect methods of intra-abdominal pressure measurement in normal horses. J Vet Emerg Crit Care [Internet]. 2009; 19(6):545–53. http://doi.org/10.1111/j.1476-4431.2009.00482.x.

19. Munsterman AS, Hanson RR. Evaluation of gastric pressures as an indirect method for measurement of intraabdominal pressures in the horse. J Vet Emerg Crit Care [Internet]. John Wiley & Sons, Ltd (10.1111); 2011; 21(1):29–35. Available from: http://doi.wiley.com/10.1111/j.1476-4431.2010.00608.x

20. Canola PA, Perotta JH, Dias DPM, Canola JC, Valadão CAA. Indirect measurement of abdominal pressure in horses. In: World Equine Veterinary Association, editor. Proceedings of the 11th International Congress of the World Equine Veterinary Association; 2009. 68–9. Available from: www.ivis.org

21. Desie N, Willems A, De Laet I, Dits H, Van Regenmortel N, Schoonheydt K, et al. Intra-abdominal pressure measurement using the FoleyManometer does not increase the risk for urinary tract infection in critically ill patients. Ann Intensive Care [Internet]. Springer; 2012; 2 (1):S10. http://doi.org/10.1186/2110-5820-2-S1-S10.

22. Gallagher JJ. Intra-abdominal Hypertension. AACN Adv Crit Care [Internet]. 2010; 21(2):205–17. doi: 10.1097/NCI.0b013e3181d94fd5 20431449

23. Hart S, Drevets K, Alford M, Salacinski A, Hunt BE. A method-comparison study regarding the validity and reliability of the Lactate Plus analyzer. BMJ Open [Internet]. British Medical Journal Publishing Group; 2013; 3(2):e001899. doi: 10.1136/bmjopen-2012-001899 23449745

24. Berkman C, Pereira MC, Nardi KB, Pereira GT, Soares OAB, Restan WAZ, et al. Agreement between i-STAT and YSI 2300 devices to determine lactate concentrations in dogs undergoing exercise. Comp Exerc Physiol [Internet]. Wageningen Academic Publishers; 2016; 12(2):75–82. http://doi.org/10.3920/CEP160002.

25. Wilkins PA. Abdominal compartment syndrome in equine medicine. In: American College of Veterinary Internal Medicine, editor. 23rd annual veterinary medical forum; 2005. Available from: https://www.worldcat.org/title/acvim-23rd-annual-veterinary-medical-forum-2005/oclc/500284073&referer=brief_results

26. Ludbrook J. Statistical techniques for comparing measurers and methods of measurement: a critical review. Clin Exp Pharmacol Physiol [Internet]. 2002; 29(7):527–36. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12060093. doi: 10.1046/j.1440-1681.2002.03686.x 12060093

27. Kimball EJ, Baraghoshi GK, Mone MC, Hansen HJ, Adams DM, Alder SC, et al. A Comparison of Infusion Volumes in the Measurement of Intra-Abdominal Pressure. J Intensive Care Med [Internet]. SAGE PublicationsSage CA: Los Angeles, CA; 2009; 24(4):261–8. doi: 10.1177/0885066609335730 19617230

28. Hines M. Differential Diagnosis of Urinary Incontinence and Cauda Equina Syndrome. In: Equine Neurology [Internet]. Knoxville, USA: John Wiley & Sons, Inc; 2015. p.139–40. Available from: http://doi.wiley.com/10.1002/9781118993712.ch12

29. Shier D, Butler J, Lewis R. Urinary System. In: Hole’s essentials of human anatomy & physiology [Internet]. 11th ed. 2012. p. 467–84. Available from: https://the-eye.eu/public/Books/Medical/texts/Hole%27sEssentialsofHumanAnatomy%2CPhysiol.10thed.—D.Shier%2Cet.al.%2C%28McGraw-Hill%2C2009%29WW.pdf

30. Pielou N. Urinary System. In: ARCHIVES, editor. Anatomy and Physiology For First Aiders [Internet]. 2005. p. 1–4. Available from: https://anatomy4fa.com/anatomy-physiology-for-first-aiders-anp/anp-urinary_system/

31. Toribio RE. Essentials of Equine Renal and Urinary Tract Physiology. Vet Clin North Am Equine Pract [Internet]. 2007; 23(3):533–61. doi: 10.1016/j.cveq.2007.09.006 18061849

32. Carvalho MB. Semiologia do Sistema Urinário. In: Semiologia Veterinária: a Arte do Diagnóstico [Internet]. Roca. São Paulo; 2014. p. 428–48. Available from: https://social.stoa.usp.br/articles/0031/7330/9_Semiologia_do_Sistema_Urinário.pdf

33. TORTORA GJ, DERRICKSON B. Sistema Urinário. In: Artmed, editor. Corpo Humano: Fundamentos de Anatomia e Fisiologia [Internet]. 10th ed. Porto Alegre; 2017. p. 541. Available from: http://www.ufrgs.br/bibicbs/livros-novos/tortora-corpo-humano-10.-ed

34. KÖNIG HE, LIEBICH H-G. Sistema Urinário. In: Artmed, editor. Anatomia dos animais domésticos [Internet]. 6th ed. Porto Alegre; 2016. p. 409. Available from: http://www.ufrgs.br/bibicbs/livros-novos/konig-anatomia-dos-animais-domesticos

35. Ribeiro CCR, Toufen Junior C, Franca SA. Ventilação mecânica: princípios, análise gráfica e modalidades ventilatórias. J Bras Pneumol [Internet]. 2007; 33(2):S54–70. Available from: http://www.scielo.br/pdf/jbpneu/v33s2/a02v33s2.pdf

36. Ahmadi-Noorbakhsh S, Malbrain ML. Integration of inspiratory and expiratory intra-abdominal pressure: a novel concept looking at mean intra-abdominal pressure. Ann Intensive Care [Internet]. Springer; 2012; 2 Suppl 1(Suppl 1):S18. http://doi.org/10.1186/2110-5820-2-S1-S18.


Článek vyšel v časopise

PLOS One


2019 Číslo 10

Nejčtenější v tomto čísle

Tomuto tématu se dále věnují…


Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

Léčba bolesti v ordinaci praktického lékaře
nový kurz
Autoři: MUDr. PhDr. Zdeňka Nováková, Ph.D.

Revmatoidní artritida: včas a k cíli
Autoři: MUDr. Heřman Mann

Jistoty a nástrahy antikoagulační léčby aneb kardiolog - neurolog - farmakolog - nefrolog - právník diskutují
Autoři: doc. MUDr. Štěpán Havránek, Ph.D., prof. MUDr. Roman Herzig, Ph.D., doc. MUDr. Karel Urbánek, Ph.D., prim. MUDr. Jan Vachek, MUDr. et Mgr. Jolana Těšínová, Ph.D.

Léčba akutní pooperační bolesti
Autoři: doc. MUDr. Jiří Málek, CSc.

Nové antipsychotikum kariprazin v léčbě schizofrenie
Autoři: prof. MUDr. Cyril Höschl, DrSc., FRCPsych.

Všechny kurzy
Kurzy Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Nemáte účet?  Registrujte se

Zapomenuté heslo

Zadejte e-mailovou adresu se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se