Acute Effect of Intraabdominal Pressure on Liver and Systemic Circulation

Abstract

Intraabdominal and retroperitoneal hematoma due to abdominal trauma and surgery increase patients' intraabdominal pressure (IAP) and worsen their condition. In some cases, these hepatic and renal dysfunctions without primary shock. To clarify the pathogenicities, 7 mongrel dogs were subjected to the fol lowing experimental proctocol. Systemic blood pressure (BP), cardiac output (CO), portal vein flow (PVF), portal vein pressure (PVP), bile duct pressure (BDP), and femoral vein pressure (FVP), were measured at IAP levels of 0, 10, 20, 30, and 40 mmHg by infusing colloid sollution into the abdominal cavity. Analysis of the relationship between IAP and those factors showed the follow ing : (1) Although there was a poor relationship between IAP and BP, IAP had good correlation with PVP (p < 0.001; (2) IAP had an inverse relation to CO (p < 0.001) and PVF (p < 0.02); and (3) FVP was the most sensitive indicator in monitoring IAP (p < 0.05). These results suggest that the increased IAP should have an influence on liver function without producing shock, because of it effect on PVP and PVF.