Effect of intra-abdominal volume increment on lungs in hemorrhagic shock.

Abstract

Intra-abdominal hypertension (IAH) causes lung dysfunction in patients after hemorrhagic shock resuscitation. We performed intra-abdominal volume increment (IAVI) to IAH and studied its effect on pulmonary function. Eight minipigs established for IAH model by exsanquination until shock, incomplete blockage of portal vein and overload resuscitation were randomly divided into IAVI group (n=4) and sham-operated control group (n=4). Bladder pressure, arterial blood gas analysis and thoraco-abdominal computed tomography (CT) scans were measured. The minipigs were sacrificed 26 h after surgery, and lung samples were harvested for measuring the wet-to-dry weight ratio and hematoxylin-eosin staining. Compared with sham-operated control group, the respiratory rate and paCO2 remarkably decreased and paO2 notably increased at 8 and 12 h in the IAVI group. The bladder pressure also notably decreased at 8, 12, and 22 h after IAVI treatment. However, a significant improvement in diaphragm height was observed at 22 h after IAVI treatment. The wet-to-dry weight ratio of the lungs in IAVI group was also significantly higher than that that in the sham-operated control group. Our data indicate that IAVI surgery could improve the damaged pulmonary function caused by IAH after hemorrhagic shock resuscitation (Tab. 1, Fig. 7, Ref. 21).