Hemorheological factors can be informative in comparing treatment possibilities ofabdominal compartment syndrome.

Abstract

Abdominal compartment syndrome (ACS) is alife-threatening condition, of which pathomechanism hasn't been completely clarified, yet. Furthermore, surgical therapy still needs optimization. We aimed to investigate microcirculatory and micro-rheological alterations in ACS, using various temporary abdominal closure methods, including three settings of vacuum-assisted closure technique (negative pressure wound therapy, NPWT). On anesthetized pigs, by intraabdominally placed and filled-up silicone bags, intraabdominal pressure at 30 mmHg was maintained for 3hours, and afterwards, decompressive laparotomy happened. In different experimental groups Bogota-bag or Vivano abdominal sets were applied (-50, -100, -150 mmHg) for 2hours. Pressure monitoring was done by implanted sensors, hemorheological parameters were determined, and laser Doppler flowmetry tests were performed on the surface of intraabdominal organs. Treatment with Bogota-bag and -150 mmHg vacuum increased erythrocyte aggregation, while deformability declined. Blood viscosity increased after treatment with -150 mmHg vacuum. The microcirculatory parameters of the NPWT groups were better in small intestine. ACS resulted in impairment of macro- and micro-rheological parameters and abdominal organs' microcirculation. All of the used techniques improved the results, however, applying Bogota-bag or -150 mmHg vacuum set showed worse microcirculatory and micro-rheological data than the settings at -100 or -50 mmHg.