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Fukuda K, Kaneko J, Kiritani S, Sawa Y, Morito M, Tanaka M, Ushiku T, Cheng CJ, Tanaka T, Tanaka R, Asakura T, Kawaguchi Y, Akamatsu N, Hasegawa K. Thick silk fibroin vascular graft: A promising tissue-engineered scaffold material for abdominal vein grafts in middle-sized mammals. Int J Artif Organs 2024; 47:190-197. [PMID: 38419137 DOI: 10.1177/03913988241234547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Abdominal vein replacement with synthetic tissue-engineered vascular grafts constructed from silk-based scaffold material has not been reported in middle-sized mammals. Fourteen canines that underwent caudal vena cava replacement with a silk fibroin (SF) vascular graft (15 mm long and 8 mm diameter) prepared with natural silk biocompatible thread were allocated to two groups, thin and thick SF groups, based on the graft wall thickness. The short-term patency rate and histologic reactions were compared. The patency rate at 2 weeks after replacement in the thin and thick SF groups was 50% and 88%, respectively (p = 0.04). CD31-positive endothelial cells covered the luminal surface of both groups at 4 weeks. The elastic modulus of the thick SF graft was significantly better than that of the thin SF graft (0.0210 and 0.0007 N/m2, p < 0.01). Roundness of thick SF groups (o = 0.8 mm) was better than thin SF (o = 2.0 mm). There was significant difference between the groups (p = 0.01). SF vascular grafts are a promising tissue-engineered scaffold material for abdominal venous system replacement in middle-sized mammals, with thick-walled grafts being superior to thin-walled grafts.
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Affiliation(s)
- Kaito Fukuda
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Junichi Kaneko
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Sho Kiritani
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yui Sawa
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Masaaki Morito
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Mariko Tanaka
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Chieh-Jen Cheng
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan
| | - Takashi Tanaka
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan
| | - Ryo Tanaka
- Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan
| | - Tetsuo Asakura
- Department of Biotechnology, Tokyo University of Agriculture and Technology, Koganei, Fuchu, Tokyo, Japan
| | - Yoshikuni Kawaguchi
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Nobuhisa Akamatsu
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kiyoshi Hasegawa
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Gardner AK, Schroeder EL. Pathophysiology of intraabdominal hypertension and abdominal compartment syndrome and relevance to veterinary critical care. J Vet Emerg Crit Care (San Antonio) 2022; 32:48-56. [PMID: 35044059 DOI: 10.1111/vec.13125] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 01/16/2018] [Accepted: 01/20/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Increased intraabdominal pressure, termed intraabdominal hypertension (IAH), is reported as an independent cause of morbidity and mortality in the human ICU but, until recently, has been rarely described in veterinary species outside of experimental models. Failure to identify severe IAH leads to organ dysfunction, termed abdominal compartment syndrome, and rapidly becomes fatal without therapeutic intervention. Although the veterinary community has been slow to address the concept of IAH and associated comorbidities, recent companion and large animal case series and experimental studies suggest IAH may also be common in veterinary species and correlates well with risk factors and grading systems already described in the human literature. PATHOPHYSIOLOGY Increasing abdominal pressures exert deleterious local effects through visceral ischemia and reperfusion injury as well as systemic effects on the cardiovascular, pulmonary, renal, and central nervous systems. Even mild grades of IAH increase systemic vascular resistance, impede venous return, increase pulmonary wedge pressure, and decrease pulmonary function. More severe grades cause azotemia, oliguria, decreased coronary blood flow, hypoxia, increased intracranial pressure, and death. IMPORTANCE Many of the common diseases in veterinary patients are associated with IAH, including gastric dilatation-volvulus, colon volvulus, closed pyometra, hemoperitoneum, ascites, uroperitoneum, and hydrops. Monitoring of the veterinary patient is difficult, but several experimental studies validate both the presence of IAH and the ability to monitor abdominal pressures in large and small animal species. Moreover, prompt recognition of IAH and subsequent treatment is feasible in the veterinary ICU. KEY POINTS Increasing abdominal pressures exert deleterious local effects through visceral ischemia and reperfusion injury as well as systemic effects on the cardiovascular, pulmonary, renal, and central nervous systems. Increases in central venous pressure, systemic vascular resistance, pulmonary wedge pressure, and a decreased cardiac output by way of both decreased preload and increased afterload have been documented as a result of intraabdominal hypertension (IAH). Direct diagnosis of IAH is achieved by blind or ultrasound-guided abdominal needle puncture attached to a water manometer or direct pressure monitoring transducer. Transvesicular measurement of intraabdominal pressure (IAP) is relatively noninvasive, and many patients that would benefit from rapid diagnosis of IAH and abdominal compartment syndrome already have indwelling bladder catheters. Recommendations for interventions are based on the assigned grade of IAH (mild, moderate, severe). KEY POINTS If IAH is strongly suspected or diagnosed, abdominal wall compliance may be improved through judicious use of neuromuscular blockers and sedation. Decompression, either minimally invasive or surgical, is absolutely recommended for IAPs consistently above 20 mm Hg, especially in the presence of signs attributed to secondary organ dysfunction.
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Affiliation(s)
- Alison K Gardner
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Eric L Schroeder
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
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Jang M, Son W, Kim H, Won Shin C, Lee I. Effect of intra-abdominal hypertension on the intraocular pressure of the conscious dogs. Vet Med Sci 2021; 7:642-646. [PMID: 33527724 PMCID: PMC8136941 DOI: 10.1002/vms3.441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 08/17/2020] [Accepted: 01/04/2021] [Indexed: 12/24/2022] Open
Abstract
This study was performed to evaluate the effect of intra-abdominal pressure (IAP) on intraocular pressure (IOP) in conscious dog models using a balloon technique to generate intra-abdominal hypertension. Six healthy dogs without ocular abnormalities were evaluated in this study. A balloon device was placed in the intra-abdominal cavity. The abdomen was insufflated to IAP levels of 15 and 25 mmHg using the balloon device. Intraocular pressure was measured at baseline, at IAP levels of 15 and 25 mmHg, and after decompression. In comparison with the mean baseline IOP (15.1 ± 2.0 mmHg), there was a significant increase in IOP at IAP levels of 15 mmHg (20.0 ± 2.1 mmHg) and 25 mmHg (19.9 ± 2.2 mmHg), corresponding to a 32.4% and 31.7% increase from baseline IOP, respectively. The mean IOP after decompression (14.8 ± 1.7 mmHg) was significantly lower compared to those at IAP levels of 15 and 25 mmHg. The present findings demonstrate that increased IAP has a clinically significant effect on IOP in dogs under conscious conditions. Although more research is needed to determine of increased IAP on IOP, these findings suggest that increased IAP leads to mild and reversible increase in IOP.
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Affiliation(s)
- Min Jang
- Department of Veterinary Clinical SciencesCollege of Veterinary MedicineSeoul National UniversitySeoulKorea
- Department of Veterinary SurgeryCollege of Veterinary MedicineKyungpook National UniversityDaeguRepublic of Korea
| | - Won‐Gyun Son
- Department of Veterinary Clinical SciencesCollege of Veterinary MedicineSeoul National UniversitySeoulKorea
| | - Hyunseok Kim
- Department of Veterinary Clinical SciencesCollege of Veterinary MedicineSeoul National UniversitySeoulKorea
| | - Chi Won Shin
- Department of Veterinary Clinical SciencesCollege of Veterinary MedicineSeoul National UniversitySeoulKorea
| | - Inhyung Lee
- Department of Veterinary Clinical SciencesCollege of Veterinary MedicineSeoul National UniversitySeoulKorea
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Lapa KH, Tony Mann FA, Jackson ML, Kerl ME. Comparison of right lateral versus left lateral versus sternal recumbence intra-abdominal pressure measurements in normal dogs. J Vet Emerg Crit Care (San Antonio) 2020; 30:249-253. [PMID: 32329569 DOI: 10.1111/vec.12953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 06/05/2017] [Accepted: 06/17/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine if there is a difference in intra-abdominal pressure (IAP) among 3 anatomic body positions (right lateral, left lateral, and sternal recumbence) in apparently healthy dogs. DESIGN Prospective, observational study. SETTING University Veterinary Medical Teaching Hospital. ANIMALS Fourteen apparently healthy male dogs. MEASUREMENTS AND MAIN RESULTS After mild sedation with dexmedetomidine, a water manometer attached to a Foley urinary catheter was used to measure IAP in 3 different body positions in each dog. There was no significant difference in IAP between right lateral (3.87± 3.16 cm H2 O), left lateral (4.45 ± 3.22 cm H2 O), and sternal recumbence (4.04 ± 3.57 cm H2 O). CONCLUSIONS Based on data from these 14 apparently healthy dogs, these 3 body positions can be used interchangeably for monitoring an individual dog. However, more research in dogs is needed to see if this conclusion holds true when IAP is abnormal.
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Affiliation(s)
- Klayton H Lapa
- Department of Veterinary Medicine and Surgery, University of Missouri College of Veterinary Medicine, 900 East Campus Drive, Columbia, Missouri, 65211, United States
| | - F A Tony Mann
- Department of Veterinary Medicine and Surgery, University of Missouri College of Veterinary Medicine, 900 East Campus Drive, Columbia, Missouri, 65211, United States
| | - Mary L Jackson
- Department of Veterinary Medicine and Surgery, University of Missouri College of Veterinary Medicine, 900 East Campus Drive, Columbia, Missouri, 65211, United States
| | - Marie E Kerl
- Department of Veterinary Medicine and Surgery, University of Missouri College of Veterinary Medicine, 900 East Campus Drive, Columbia, Missouri, 65211, United States
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de Paula VB, Canola PA, Rivera GG, Bonacin YS, Del Rio LA, Canola JC, Ferraudo AS. Intra-abdominal Pressure Screening of Horses With Colic. J Equine Vet Sci 2020; 90:102998. [PMID: 32534775 DOI: 10.1016/j.jevs.2020.102998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/16/2020] [Accepted: 03/20/2020] [Indexed: 12/13/2022]
Abstract
The objective of this study was to evaluate changes in intra-abdominal pressure (IAP) in horses with colic by associating the underlying etiologies with directly acquired IAP values and survival rate. This is a 2-year cohort study (2014-2016). Horses with clinical signs of colic were admitted to the veterinary teaching hospital during the period 2014-2016. Twenty-eight horses, of different breeds, males (stallions and geldings) and females, aged between 2 and 20 years, and weighing from 300 to 450 kg presenting with clinical signs of colic, were included in the study. IAP was directly acquired at the right flank (standing under sedation) and at the linea alba (supine position under general anesthesia). Twenty IAP measurements were recorded at end expiration for each recording site. IAP values >0.0 mmHg, obtained at the upper right flank in the standing position, were associated with surgical treatment (P < .05). In these cases, signs of colic were associated with strangulated obstructions of the large colon, and a greater likelihood of death as a result of colic (P < .001). Intra-abdominal pressure varied considerably in horses with colic, even for the same underlying etiologies. Horses with colic related to strangulating obstructions of the large intestine had IAP >.0 mmHg, at the upper right flank. These horses were also considerably more likely to require surgical intervention (P < .05) and death/euthanasia was more likely in this group of horses (P < .001).
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Affiliation(s)
- Vanessa B de Paula
- São Paulo State University (Unesp), School of Agricultural and Veterinarian Sciences, Jaboticabal, SP, Brazil
| | - Paulo A Canola
- Department of Veterinary Medicine and Surgery, São Paulo State University (Unesp), School of Agricultural and Veterinarian Sciences, Jaboticabal, SP, Brazil.
| | - Gabriela G Rivera
- São Paulo State University (Unesp), School of Agricultural and Veterinarian Sciences, Jaboticabal, SP, Brazil
| | - Yuri S Bonacin
- São Paulo State University (Unesp), School of Agricultural and Veterinarian Sciences, Jaboticabal, SP, Brazil
| | - Lara A Del Rio
- Crispim and Stevanato Veterinary Hospital, Mirassolândia, SP, Brazil
| | - Júlio C Canola
- Department of Veterinary Medicine and Surgery, São Paulo State University (Unesp), School of Agricultural and Veterinarian Sciences, Jaboticabal, SP, Brazil
| | - Antônio S Ferraudo
- Department of Mathematical Sciences, São Paulo State University (Unesp), School of Agricultural and Veterinarian Sciences, Jaboticabal, SP, Brazil
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Son H, Ko J, Jeong J, Lee S, Sihn D, Kweon OK, Kim WH. Cardiopulmonary changes induced by retroperitoneal insufflation in healthy dogs in sternal recumbency with the abdomen unsupported. J Vet Med Sci 2019; 82:94-100. [PMID: 31801923 PMCID: PMC6983665 DOI: 10.1292/jvms.19-0330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study assessed the effects of retroperitoneal carbon dioxide (CO2) insufflation on cardiopulmonary variables and intra-abdominal pressure (IAP) in mechanically ventilated dogs in sternal recumbency with the abdomen unsupported, following placement of a positioning kit and towels under the pectoral and pelvic regions. General anesthesia was induced in eight healthy adult male Beagles. A Swan-Ganz catheter was placed in the pulmonary artery via the jugular vein for cardiac output measurements. A Foley urethral catheter was placed to monitor transvesical IAP. A 10 mm balloon blunt-tip trocar was inserted into the retroperitoneal space. With a fixed respiratory rate and tidal volume by mechanical ventilation, insufflation pressure was sequentially increased from 0 to 10 mmHg in 5 mmHg increments, followed by desufflation. All variables were measured before insufflation, 5 min after the establishment of each insufflation pressure, and after desufflation. At 10 mmHg, the IAP was nearly equal to insufflation pressure. Cardiopulmonary function was not compromised at any point, although the cardiac index (CI), heart rate, mean arterial pressure (MAP), and mean pulmonary arterial pressure increased within normal ranges. End-tidal CO2 concentration, arterial CO2 partial pressure, and oxygen delivery index (DO2I) increased, whereas pH decreased, at 10 mmHg. CI, MAP, and DO2I did not recover to baseline after decompression. Thus, retroperitoneal CO2 insufflation up to 10 mmHg is well tolerated by mechanically ventilated dogs positioned in sternal recumbency with the abdomen unsupported, although sympathetic changes may occur with an insufflation pressure increase.
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Affiliation(s)
- Hyunglak Son
- Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Jonghyeok Ko
- Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Junemoe Jeong
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA
| | - Sungin Lee
- Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Dongmin Sihn
- Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Oh-Kyeong Kweon
- Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Wan Hee Kim
- Department of Veterinary Clinical Science, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
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Jang M, Son WG, Jo SM, Kim H, Shin CW, Lee I. Effect of intra-abdominal hypertension on plasma exogenous creatinine clearance in conscious and anesthetized dogs. J Vet Emerg Crit Care (San Antonio) 2019; 29:366-372. [PMID: 31215748 DOI: 10.1111/vec.12853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 05/11/2017] [Accepted: 05/20/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To evaluate the effect of intra-abdominal pressure (IAP) on plasma exogenous creatinine clearance in both conscious and anesthetized dog models using a balloon technique to generate intra-abdominal hypertension. DESIGN Prospective, cross-over, experimental study. SETTING University-based small animal research facility. ANIMALS Six healthy male Beagle dogs. INTERVENTIONS A balloon device comprising a Foley urinary catheter and latex balloon was placed in the intra-abdominal cavity. Plasma exogenous creatinine clearance was compared after intravenous administration of exogenous creatinine solution at 80 mg/kg under 4 different treatment conditions as follows: control and IAP levels of 25 mm Hg in conscious dogs and control and IAP levels of 25 mm Hg in anesthetized dogs (CC, C25, AC, and A25, respectively). Samples were obtained before (T0) and 10, 20, 30, 60, 90, 120, 240, 360, 480, and 600 min after administration of creatinine in all treatment groups. MEASUREMENTS AND MAIN RESULTS There were no significant differences in plasma creatinine concentration for CC, AC, and C25 during the treatment period. However, in the A25 treatment condition, the plasma creatinine concentration increased significantly at 10, 20, 30, 60, 90, and 120 min after administration of creatinine (P < 0.05). Plasma creatinine clearances were 5.0 ± 0.5, 4.7 ± 1.2, 5.5 ± 0.9, and 2.5 ± 0.5 mL/kg/min for 600 min (CC, AC, C25, and A25, respectively). In the A25 treatment condition, the plasma exogenous creatinine clearance decreased significantly to 50%, 47%, and 55% of that under control conditions (CC, AC, and C25, respectively). After decompression of the abdomen, plasma creatinine concentrations declined rapidly and returned to basal concentrations. CONCLUSIONS Intra-abdominal hypertension under general anesthesia could cause renal hypoperfusion. Timely decompression may improve the outcome of acutely increased IAP when surgery and/or general anesthesia is required in canine patients.
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Affiliation(s)
- Min Jang
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Korea
| | - Won-Gyun Son
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Korea
| | - Sang-Min Jo
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Korea
| | - Hyunseok Kim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Korea
| | - Chi Won Shin
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Korea
| | - Inhyung Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Korea
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Jang M, Choi S, Lee I, Lee I. Computed tomographic features of intra-abdominal hypertension in three dogs. J Vet Emerg Crit Care (San Antonio) 2019; 29:185-189. [PMID: 30742356 DOI: 10.1111/vec.12810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 02/01/2017] [Accepted: 05/16/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe computed tomographic (CT) features of intra-abdominal hypertension (IAH) in 3 dogs with abdominal distension. CASE SUMMARY Three dogs with anorexia, distended abdomen, or labored breathing were presented for CT imaging. All 3 dogs were premedicated with IV butorphanol (0.2 mg/kg). A Foley urinary catheter was aseptically placed and the transvesical technique was used to obtain intra-abdominal pressure (IAP). The IAP measurements were obtained with the dogs in a standing position after a stabilization period of 5 minutes. The mean IAP values for each of the 3 dogs were 26.0, 12.0, and 13.0 mm Hg. Anesthesia was induced with IV propofol (2.0-4.0 mg/kg, to effect) in all 3 dogs and maintained with sevoflurane in 2 dogs. Compression of the caudal vena cava and elevation of the diaphragm were observed in all 3 dogs, whereas renal compression and the extension of peritoneal fluid to the vaginal canal and cavity were seen in the dog with the highest IAP. NEW OR UNIQUE INFORMATION PROVIDED Compression of the caudal vena cava, direct renal compression, and the extension of peritoneal fluid into the vaginal canal and vaginal cavity are consistent with a diagnosis of IAH. Measurement of IAP and detection of these CT features should alert clinicians to the possible presence of IAH in veterinary patients.
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Affiliation(s)
- Min Jang
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, South Korea.,Ian Animal Diagnostic, Imaging Center, Seoul, South Korea
| | - Sooyoung Choi
- Ian Animal Diagnostic, Imaging Center, Seoul, South Korea.,College of Veterinary Medicine, Kangwon National University, Chuncheon, South Korea
| | - In Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, South Korea.,Ian Animal Diagnostic, Imaging Center, Seoul, South Korea
| | - Inhyung Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
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Jang M, Son WG, Jo SM, Kim H, Shin CW, Lee I. A novel balloon technique to induce intra-abdominal hypertension and its effects on cardiovascular parameters in a conscious dog model. J Vet Emerg Crit Care (San Antonio) 2018; 28:326-333. [PMID: 29898239 DOI: 10.1111/vec.12730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 08/11/2016] [Accepted: 08/19/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To evaluate a new balloon technique to induce intra-abdominal hypertension (IAH) and abdominal compartment syndrome in a conscious dog model, and to evaluate the effect of intra-abdominal pressure (IAP) on cardiovascular, respiratory, and arterial blood gas values in conscious dogs with IAH. DESIGN Prospective, experimental study. SETTING University-based small animal research facility. ANIMALS Six healthy Beagle dogs, 4 males, and 2 females. INTERVENTIONS A new balloon device designed for this study using a Foley urethral catheter and latex balloon was placed in the abdominal cavity. Consecutive measurements of IAP were made by measuring the intravesicular pressure. The abdomen was inflated with air to IAPs of 10, 15, 20, and 25 mm Hg. Heart rate, respiratory rate, systolic arterial blood pressure, and arterial blood gases were evaluated at baseline and at 15, 30, 45, 60, 120, 240, and 300 minutes after IAP increase. MEASUREMENTS AND MAIN RESULTS The air insufflated into the intra-abdominal balloon device significantly increased the IAP and led to sustained IAH. The respiratory rate increased significantly (P < 0.05) when IAP was increased to 15, 20, and 25 mm Hg. Although heart rate, systolic arterial blood pressure, PaO2 , and PaCO2 did not show statistically significant differences between baseline and posttreatment values over time, the dogs with increased IAP showed a distended abdomen and apparent discomfort, and 4/6 (67%) vomited. After measurement of IAP, air was removed. There were no adverse effects noted after removal of the balloon device. CONCLUSION The balloon device was successfully insufflated and led to sustained IAH in conscious dogs. This balloon technique does not require general anesthesia for instillation or removal of gas after installment. An acute IAP increase in normal conscious dogs induced discomfort, vomiting, and increased respiratory effort.
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Affiliation(s)
- Min Jang
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Korea.,the Ian Animal Diagnostic Imaging Center, Seoul, 06014, Korea
| | - Won-Gyun Son
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Korea
| | - Sang-Min Jo
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Korea
| | - Hyunseok Kim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Korea
| | - Chi Won Shin
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Korea
| | - Inhyung Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Korea
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Shin CW, Kim H, Han H, Lee I, Son WG. Anesthesia Case of the Month. J Am Vet Med Assoc 2017; 251:399-404. [PMID: 28763277 DOI: 10.2460/javma.251.4.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Thomovsky E, Brooks A, Johnson P. Fluid Overload in Small Animal Patients. Top Companion Anim Med 2016; 31:94-99. [DOI: 10.1053/j.tcam.2016.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 08/04/2016] [Indexed: 11/11/2022]
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Salcedo MC, Tart K, Hall K. A systematic review of human and veterinary applications of noninvasive tissue oxygen monitoring. J Vet Emerg Crit Care (San Antonio) 2016; 26:323-32. [PMID: 27062438 DOI: 10.1111/vec.12465] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 08/27/2014] [Accepted: 09/15/2014] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To describe the methodology for and utilization of tissue oxygen monitoring by near infrared spectroscopy, and to review the current literature on the use of this monitoring modality in human and veterinary settings. DATA SOURCES Scientific reviews and original research found using the PubMed and CAB Abstract search engines with the following keywords: "tissue oxygen monitoring," "near-infrared tissue spectroscopy," and "tissue oxygen saturation (StO2 )." HUMAN DATA SYNTHESIS Tissue oxygen monitors have been evaluated in a wide variety of human clinical applications including trauma and triage, surgery, sepsis, and septic shock, and early goal-directed therapy. StO2 more rapidly identifies occult shock in human patients compared to traditional methods, which can lead to earlier intervention in these patients. VETERINARY DATA SYNTHESIS Veterinary studies involving tissue oxygen monitoring are limited, but the technology may have utility for identification of hemorrhagic shock earlier than changes in base excess, blood lactate concentration, or other traditional perfusion parameters. CONCLUSION Tissue oxygen monitoring is most commonly performed utilizing a noninvasive, portable monitor, which provides real-time, continuous, repeatable StO2 measurements. A decline in StO2 is an early indicator of shock in both human and veterinary patients. Low StO2 values in human patients are associated with increased morbidity, mortality, and length of hospitalization, as well as the development of multiple organ system dysfunction and surgical site infections.
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Affiliation(s)
- Mallory C Salcedo
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108
| | - Kelly Tart
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108
| | - Kelly Hall
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108
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Whitehead K, Cortes Y, Eirmann L. Gastrointestinal dysmotility disorders in critically ill dogs and cats. J Vet Emerg Crit Care (San Antonio) 2016; 26:234-53. [PMID: 26822390 DOI: 10.1111/vec.12449] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Revised: 07/21/2015] [Accepted: 08/30/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To review the human and veterinary literature regarding gastrointestinal (GI) dysmotility disorders in respect to pathogenesis, patient risk factors, and treatment options in critically ill dogs and cats. ETIOLOGY GI dysmotility is a common sequela of critical illness in people and small animals. The most common GI motility disorders in critically ill people and small animals include esophageal dysmotility, delayed gastric emptying, functional intestinal obstruction (ie, ileus), and colonic motility abnormalities. Medical conditions associated with the highest risk of GI dysmotility include mechanical ventilation, sepsis, shock, trauma, systemic inflammatory response syndrome, and multiple organ failure. The incidence and pathophysiology of GI dysmotility in critically ill small animals is incompletely understood. DIAGNOSIS A presumptive diagnosis of GI dysmotility is often made in high-risk patient populations following detection of persistent regurgitation, vomiting, lack of tolerance of enteral nutrition, abdominal pain, and constipation. Definitive diagnosis is established via radioscintigraphy; however, this diagnostic tool is not readily available and is difficult to perform on small animals. Other diagnostic modalities that have been evaluated include abdominal ultrasonography, radiographic contrast, and tracer studies. THERAPY Therapy is centered at optimizing GI perfusion, enhancement of GI motility, and early enteral nutrition. Pharmacological interventions are instituted to promote gastric emptying and effective intestinal motility and prevention of complications. Promotility agents, including ranitidine/nizatidine, metoclopramide, erythromycin, and cisapride are the mainstays of therapy in small animals. PROGNOSIS The development of complications related to GI dysmotility (eg, gastroesophageal reflux and aspiration) have been associated with increased mortality risk. Institution of prophylaxic therapy is recommended in high-risk patients, however, no consensus exists regarding optimal timing of initiating prophylaxic measures, preference of treatment, or duration of therapy. The prognosis for affected small animal patients remains unknown.
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Affiliation(s)
- KimMi Whitehead
- Emergency and Critical Care Department, Oradell Animal Hospital, Paramus, NJ, 07452
| | - Yonaira Cortes
- Emergency and Critical Care Department, Oradell Animal Hospital, Paramus, NJ, 07452
| | - Laura Eirmann
- the Nutrition Department (Eirmann), Oradell Animal Hospital, Paramus, NJ, 07452
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Haskins SC. Letter to the editor. J Vet Emerg Crit Care (San Antonio) 2012; 22:526; author reply 526-7. [PMID: 23110566 DOI: 10.1111/j.1476-4431.2012.00810.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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