Effect of intra-abdominal volume increment technique for the treatment of intra-abdominal hypertension on the liver after resuscitation of hemorrhagic shock in pig

Objective To observe the effect of vacuum sealing drainage (VSD) assisted intra-abdominal volume increment (IAVI) technique on the liver in the treatment of intra-abdominal hypertension (IAH) following hemorrhagic shock resuscitation in pigs. Methods Twelve healthy mini-pigs (Bama, Guangxi) were selected for bloodletting from the femoral artery to reproduce hemorrhagic shock model (mean arterial blood pressure, 50mmHg, 1h), and IAH model was successfully reproduced in eight pigs by partial occlusion of portal vein. The eight pigs were randomly divided into the intra-abdominal volume increment treatment (IT) group (n=4) and sham operation control (SC) group (n=4). Vesical pressure (VP) and inferior vena cava pressure (IVCP) were observed before shock, 2h after IAH, and 22h after IAVI treatment. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured. In addition, the ratio of the abdominal anteroposterior diameter to the transverse diameter was assessed, and the liver CT values were measured after enhanced CT scanning. The pigs were sacrificed 26h after operation. Liver specimens were collected to measure the ratio of wet weight to dry weight and pathological examination. Results The VP in 8 IAH pigs was 21.16±4.63mmHg. The ratio of abdominal anteroposterior diameter to the transverse diameter increased remarkably 2h after IAH compared with that before shock (1.22±1.41 vs 0.96±0.08, PPvs 42.73±4.92HU, PPPvs 5.14±0.71, PConclusions The established model could better reproduce the symptoms of IAH after hemorrhagic shock and fluid resuscitation, accompanied by liver damage. IAVI helps to relieve liver functional disturbance after IAH, which is related to decreased intra-abdominal pressure and hypoxia-ischemia of the liver.