EFFECTS OF INTRABLADDER VOLUMES AND ABDOMINAL PRESSURE INCREMENTS ON INDIRECT INTRA-ABDOMINAL PRESSURE MONITORING IN HORSES

• Grant number: 18/24287-0
• Support Opportunities: Regular Research Grants
• Start date: March 01, 2019
• End date: February 28, 2021
• Field of knowledge: Agronomical Sciences - Veterinary Medicine - Animal Clinics and Surgery
• Principal Investigator: Paulo Aléscio Canola
• Grantee: Paulo Aléscio Canola
• Host Institution: Faculdade de Ciências Agrárias e Veterinárias (FCAV). Universidade Estadual Paulista (UNESP). Campus de Jaboticabal. Jaboticabal , SP, Brazil

Abstract

Intra-abdominal pressure (IAP) is defined as the pressure concealed within abdomen, formed from the abdominal wall coupled with visceral content. Its increase to the point at which organ functionality is limited, intra-abdominal hypertension (HIA) or abdominal compartment syndrome (ACS) is established, both which are responsible for increased patient morbidity and mortality. In order to diagnose these clinical features, IAP monitoring is essential. In human patients, IAP variations are routinely monitored indirectly, through intrabladder pressure (IBP) recordings. Previous studies in horses have attempted to validate indirect assessments of IAP, but none of them have succeeded so far. However, more recently, our group reassessed the efficacy of an indirect method of IAP monitoring in horses, with promising results (FAPESP 2016/00496-4). Therefore, as an ad continuing of our previous study we sought to identify the optimal volume for bladder distension as well as investigate the effects of bladder distension volumes on IBP values and its efficiency on estimating IAP (phase I). Furthermore, we ought to investigate the efficiency of IBP in estimating IAP in face iatrogenic intra-abdominal hypertension, created by visceral (cecum) distension (phase II). Eight horses, males (geldings and stallions) and females, weighting between 350 and 500 kg, aged between 3.5 and 12 years old will be include on the study. The animals are part of our research group heard and already have been submitted typhlopexy as part of a previous study (FAPESP 2015/24860-4). Intra-abdominal pressure will be recorded by intraperitoneal cannula, positioned at the linea alba, 10 cm caudal to the xiphoid, and connected to a fluid-filled system (central venous pressure water column system), zeroed at the level of insertion of the cannula. Intravesical pressure will be obtained from bladder catheterization, by using the same fluid-filled system, individually zeroed at the level of the pubic symphysis (lateral recumbency). Volumes up to 500 ml (increments of 50 ml from an emptied bladder) will be used for that purpose. Iatrogenic Intra-abdominal hypertension will be achieved by means of cecum distension through a foley catheter. Increments of 5,0 L of saline solutoin will be used for that purpose (up to maximum distension volume of 30 L). All subjects will be maintained in left lateral recumbence, by means of general anesthesia and mechanical ventilation. A wash out period of 15 days in between experimental phases will be postulated. (AU)