Abstract
ObjectivesTo investigate effects of postural changes and bladder distention on intrabladder pressure whilst estimating intra-abdominal pressure in horses.DesignTwo-year cohort study. Patients admitted for elective surgical procedures unrelated to gastrointestinal or genitourinary tract.SettingSchool of Agricultural and Veterinarian Sciences, Jaboticabal, SP, Brazil.Animals20 adult horses, 11 males (stallions and geldings) and 9 females; between 3.5 and 12 years, weighing 350 to 500 kg.InterventionsIntra-abdominal pressure was directly-recorded through abdominocentesis at the ventral midline with a fluid-filled system. Intrabladder pressure was obtained from a bladder catheter with the fluid-filled system zeroed at the level of the tuber ischia with patients in dorsal recumbency or pubic symphysis if in lateral recumbency.Measurements and main resultsBody position directly influenced intra-abdominal pressure. In dorsal recumbency, intra-abdominal pressure differed (p < 0.05) from intrabladder pressure at end-inspiration and end-expiration regardless of whether the bladder was empty or distended. There was no correlation nor association between the two pressures in this body position. In lateral recumbency a difference (p <0.05) between intra-abdominal pressure and intrabladder pressure was recorded at end-inspiration with the bladder distended with 25 ml, and at end-expiration for distension volumes of 25 ml and 50 ml. There was a strong correlation between both pressures for left and right lateral recumbency, regardless of the distension volume. Ordinary least product (OLP) regression analysis showed no fixed or proportional bias between both pressures for distension volume of 50 ml, at both end-inspiration and end-expiration.ConclusionsIndirect assessment of equine intra-abdominal pressure cannot be made in dorsal recumbency. For that purpose, patients should be in left lateral recumbency with the bladder distended with 50 ml. Values can be recorded at end-inspiration or end-expiration.RestrictionOcclusion of the catheter tip by the bladder wall when minimally distended.
Highlights
Intra-abdominal pressure (IAP) is defined as the pressure within the abdominal cavity resulting from the interaction between the abdominal wall and abdominal contents [1,2]
Indirect assessment of equine intra-abdominal pressure cannot be made in dorsal recumbency
In contrast to previous attempts, we considered whether variations in the subjects’ body position and the volume of bladder distension were factors that affect the efficacy of the method, as they do in man
Summary
Intra-abdominal pressure (IAP) is defined as the pressure within the abdominal cavity resulting from the interaction between the abdominal wall and abdominal contents [1,2]. The abdomen is considered primarily fluid in character and behaves as a homogeneous hydraulic fluid system, conforming to Pascal’s law It follows that the pressure exerted on any part of the abdominal cavity will be distributed throughout it, being isotropic when the fluid points are at the same absolute height. The point to which multiple organ disfunction syndrome (MODS) manifests as a result of severe IAH is termed abdominal compartment syndrome (ACS) [1,2,4,5,6] Both conditions are highly detrimental and potentially fatal [1,2,4,5], and can only be diagnosed by measuring IAP [4]. They have been extensively studied in men, but still poorly investigated in the horse [2,6]
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