Cardiorespiratory effects of different intraabdominal pressures in sheep: An experimental study.

Autor: do Nascimento PRL; Department of Pathology and Veterinary Clinic, Faculty of Veterinary Medicine, Fluminense Federal University, Niterói, RJ, Brazil., de Gouvêa LV; Department of Pathology and Veterinary Clinic, Faculty of Veterinary Medicine, Fluminense Federal University, Niterói, RJ, Brazil., Leite TRS; Department of Pathology and Veterinary Clinic, Faculty of Veterinary Medicine, Fluminense Federal University, Niterói, RJ, Brazil., Teixeira ALS; Department of Pathology and Veterinary Clinic, Faculty of Veterinary Medicine, Fluminense Federal University, Niterói, RJ, Brazil., da Silva PCAR; Department of Pathology and Veterinary Clinic, Faculty of Veterinary Medicine, Fluminense Federal University, Niterói, RJ, Brazil., Filho JADF; Department of Pathology and Veterinary Clinic, Faculty of Veterinary Medicine, Fluminense Federal University, Niterói, RJ, Brazil., Helayel MJSA; Department of Pathology and Veterinary Clinic, Faculty of Veterinary Medicine, Fluminense Federal University, Niterói, RJ, Brazil., Júnior AN; Department of Pathology and Veterinary Clinic, Faculty of Veterinary Medicine, Fluminense Federal University, Niterói, RJ, Brazil., da Cunha IM; Department of Pathology and Veterinary Clinic, Faculty of Veterinary Medicine, Fluminense Federal University, Niterói, RJ, Brazil., Mendonça JS; Department of Pathology and Veterinary Clinic, Faculty of Veterinary Medicine, Fluminense Federal University, Niterói, RJ, Brazil., Silva PL; Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil., Lessa DAB; Department of Pathology and Veterinary Clinic, Faculty of Veterinary Medicine, Fluminense Federal University, Niterói, RJ, Brazil.
Jazyk: angličtina
Zdroj: Physiological reports [Physiol Rep] 2022 Nov; Vol. 10 (21), pp. e15506.
DOI: 10.14814/phy2.15506
Abstrakt: Increased intraabdominal pressure (IAP) during laparoscopy can reduce venous return, but changes in respiratory system mechanics and their effect in left cardiac function are not well documented. This study evaluated the effects of different IAPs on respiratory mechanics and cardiac function in 10 healthy nonpregnant adult Santa Ines ewes randomly submitted to a crossover study using different IAPs: 0 mm Hg (G1), 10 mm Hg (G2), 12 mmHg (G3), and 15 mmHg (G4). Animals were anesthetized and mechanically ventilated (V T  = 15 ml/kg; positive end-expiratory pressure = 3 cmH 2 O; FiO 2  = 1.0). Pneumoperitoneum was induced by Hasson's trocar cannula. Variables were measured at INITIAL (IAP, 0 mmHg) and FINAL time points for each IAP after 1 h. At FINAL, driving airway pressure (ΔP, RS ), and percentage fraction of dead space (Vd/Vt) were higher in G3 and G4 than G1 (p = 0.002, difference in means [MD] 4.60, 95% CI: 7.91-1.28, and p < 0.001, MD 5.4, 95% CI: 8.7-2.0; p = 0.016, MD -9.5, 95% CI: -17.9 to -1.2; and p = 0.027, MD -8.7, 95% CI: -17.1 to -0.4). The ejection fraction and fractional shortening were lower in G3 (p = 0.039, MD -11.38, 95% CI: -0.07--22.68; p = 0.015, MD -13.05, 95% CI: -1.74--24.36) and G4 (p = 0.039, MD -9.94, 95% CI: -0.07 to -19.80; p = 0.015, MD -11.43, 95%CI: -1.57 to -21.30, respectively) than G2. In G3, the maximum pulmonary flow velocity correlated negatively with ΔP, RS (r = -0.740; p = 0.018), and Vd/Vt correlated positively with ΔP, RS (r = 0.738, p = 0.046). At IAP of 12 and 15 mm Hg impaired respiratory system mechanics, reduced left cardiac function and no change in maximum pulmonary artery flow velocity were detected. Therefore, respiratory mechanics should be monitored as an interplay to reduce left cardiac function.
(© 2022 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)
Databáze: MEDLINE
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