Abstract
Purpose
The purpose of this large-animal study was to assess the safety and effects of negative pressure therapy (NPT) when used as temporary abdominal closure in the immediate post-decompression period after abdominal compartment syndrome (ACS).
Methods
Using a hemorrhagic shock/resuscitation and mesenteric venous pressure elevation model, ACS was physiologically induced in 12 female Yorkshire swine. At decompression, animals were allocated to either NPT (n = 6) or Bogota bag (n = 6) as temporary abdominal closure and studied for a period of 48 h or until death. Outcomes measured included morbidity and mortality, as well as hemodynamic parameters, ventilator-related measurements, blood gases, coagulation factors, and organ (liver, kidney, lung, and intestinal) edema and histology at the time of death/sacrifice.
Results
All animals developed ACS. Early application of NPT was associated with decreases in mesenteric venous and central venous pressure, and significantly increased drainage of peritoneal fluid. In addition, there was no increase in the incidence of mortality, recurrent intra-abdominal hypertension/ACS, or any deleterious effects on markers of organ injury.
Conclusions
Early application of NPT in this porcine ACS model is safe and does not appear to be associated with an increased risk of recurrent intra-abdominal hypertension. The results of this animal study suggest that the application of NPT following decompression from ACS results in greater peritoneal fluid removal and may translate into augmented intestinal edema resolution secondary to more favorable fluid flux profiles.
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Acknowledgments
This study was supported by NIH Grants T32 GM 0879201 and RO1 HL 092916; Children’s Memorial Hermann Hospital Foundation; Texas Higher Education Coordination Board; Kinetic Concepts, Inc.
Conflict of interest
Funding for this project was provided, in part, by a grant from Kinetic Concepts, Inc. (to Charles S. Cox, Jr, MD).
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Shah, S.K., Jimenez, F., Walker, P.A. et al. Evaluating the effects of immediate application of negative pressure therapy after decompression from abdominal compartment syndrome in an experimental porcine model. Eur J Trauma Emerg Surg 38, 65–73 (2012). https://doi.org/10.1007/s00068-011-0136-z
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DOI: https://doi.org/10.1007/s00068-011-0136-z