- Poster presentation
- Open Access
Does intravesical pressure as an estimation of intra-abdominal pressure predict effects on portal circulation?
© BioMed Central Ltd 2006
- Published: 21 March 2006
- Portal Vein
- Feces Pellet
- Intravesical Pressure
- Small Filling
In the clinical setting, the measurement of intravesical pressure (IVP) has evolved to the gold standard for estimating intra-abdominal pressure (IAP) in critically ill patients. However, in order to study the interplay between flow and pressure in selected regions of the splanchnic circulation (e.g. in the portal vein), direct pressure measurements might be indispensable once IVP proves not accurate enough as an indirect estimate. The intention of our present study was therefore to compare IVP, a surrogate measure of IAP, and portal vein pressure (PVP) simultaneously with portal vein flow (Qpv) measurements in a pig model of fecal peritonitis.
In six anesthetized, mechanically ventilated, and instrumented pigs, fecal peritonitis was induced by inoculating autologue feces pellets suspended in saline. The IVP, PVP, and Qpv were measured before as well as 12 and 24 hours after peritonitis induction. The IAP was measured by sequentially filling with 25 and 200 ml urine and subsequently re-empting the bladder to 25 ml. The Qpv was measured by ultrasound Doppler flowmetry. IVP values at each filling step were compared with the simultaneously recorded PVP values using a Bland-Altman plot.
During peritonitis, IVP overestimates PVP, especially when the bladder is filled with large fluid volumes (200 ml). Furthermore, under these conditions even the precision of IVP as an estimate of PVP vanishes, as shown in the plots by the larger SD. Regardless of the increases in IVP and PVP, Qpv also increased with peritonitis.
MM was supported by a grant from the Alexander von Humboldt Stiftung.