Intrabladder pressure as a predictor of intra-abdominal pressure of horses in supine position or lateral recumbency

Author(s)

Vanessa Barroco de Paula

• Document type: Master's Dissertation
• Press: Jaboticabal. 2018-05-23.
• Institution: Universidade Estadual Paulista (Unesp). Faculdade de Ciências Agrárias e Veterinárias. Jaboticabal
• Defense date: 2018-02-21
• Advisor: Paulo Aléscio Canola

Abstract

We sought to correlate intra-abdominal pressure (IAP) with intravesical pressure (IBP) of horses in supine position or lateral recumbency. For that purpose, patients admitted at our hospital for elective surgical procedures not related to the gastrointestinal or genitourinary tract, during a two-year period were included on our study. During that time, 11 adult male (stallions or geldings) and 09 female horses, weighting from 350 to 500 kg, and from 3.5 to 12 years of age were selected. Patients were divided into two distinct groups (n=10) according to body position requested for surgical procedure. Intra-abdominal pressure was recorded by intraperitoneal cannula connected to a fluid-filled system (central venous pressure water column system), zeroed at the level of insertion of the cannula. Intravesical pressure was obtained from bladder catheterization, by using the same fluid-filled system, individually zeroed at the level of the tuber ischii (supine position) or pubic symphysis (lateral recumbency). Body position directly influenced IAP values. A difference (p < 0.001) between intra-abdominal and intravesical pressures, at end-inspiration (rs = 0.127, p = 0.209) and end-expiration (rs = - 0.0393, p = 0.697) was perceived when comparing supine position with lateral recumbency. Similarly, both pressures differed, with no distinct correlation between them, regardless the saline volume used for bladder distension and the moment of pressure recordings (end-inspiration or end-expiration). In addition, difference (p < 0.05) between both pressures was also noticed at patients in lateral recumbency, when IBP was obtained end-inspiration, following bladder distension with 25 ml of saline solution. At end-expiration, similar results were obtained for IBP recorded with 25 ml and 50 ml insufflation volumes. Correlation values between both pressures maintained within previous standards as lateral recumbency was divided into right and left, regardless insufflation volume used for IBP recordings. Therefore, supine position should not be used for purposes of indirect assessment of IAP. To that purpose, the patient should be kept in left lateral recumbency, the bladder should be distended with 100 ml of saline solution, and IBP readings should occur at end-inspiration. (AU)

• FAPESP's process: 16/00496-4 - Correlation between intra-abdominal and intrabladder pressure of horses in supine position or lateral recumbency
• Grantee: Vanessa Barroco de Paula
• Support Opportunities: Scholarships in Brazil - Master