Alternative Intrabladder Manometry Technique for the Indirect Measurement of Intra-abdominal Pressure in Horses

Canola, Paulo Aléscio; Perotta, João Henrique; Dias, Daniel Penteado Martins; Canola, Júlio Carlos; Johnson, Philip J.; Valadão, Carlos Augusto Araújo

doi:10.1016/j.jevs.2011.08.017

Cited by 4 publications

(21 citation statements)

References 39 publications

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“…23 In horses, indirect measurement of IAP using bladder and gastric measurements of pressure have fallen short due to the high variance and lack of repeatability within and between horses. [2][3][4][5] Currently, only direct IAP measurement is accepted in horses using a peritoneal cannula, needle, or a microsensor catheter placed in the peritoneal cavity. 2,7,45 However, the invasiveness of the procedure, as well as the risk of infection or injury to the abdominal organs, has limited its use in the clinical patient.…”

Section: Discussionmentioning

confidence: 99%

“…Measurement of IAP in humans is commonly performed using an intravesicular catheter to obtain indirect measures of pressure as they are transmitted through the wall of the bladder 23 . In horses, indirect measurement of IAP using bladder and gastric measurements of pressure have fallen short due to the high variance and lack of repeatability within and between horses 2‐5 . Currently, only direct IAP measurement is accepted in horses using a peritoneal cannula, needle, or a microsensor catheter placed in the peritoneal cavity 2,7,45 .…”

Section: Discussionmentioning

confidence: 99%

“…1 While measurement of IAP in people is readily obtained noninvasively with a bladder catheter, in horses this method, and other indirect methods of measurement of IAP, have fallen short in terms of accuracy and reproducibility. [2][3][4][5] The current recommendation for the most accurate IAP measurement in horses is with a piezo resistive microsensor catheter or metal cannula placed directly in the peritoneal space to measure pressure. 6,7 The potential risks of the procedure include injury to abdominal organs and peritonitis; therefore, a less invasive, indirect method for pressure measurement in clinical cases is sought.…”

Section: Introductionmentioning

confidence: 99%

“…Intra‐abdominal pressure (IAP) is derived from both the abdominal volume and the compliance of the abdominal wall 1 . While measurement of IAP in people is readily obtained noninvasively with a bladder catheter, in horses this method, and other indirect methods of measurement of IAP, have fallen short in terms of accuracy and reproducibility 2‐5 . The current recommendation for the most accurate IAP measurement in horses is with a piezo resistive microsensor catheter or metal cannula placed directly in the peritoneal space to measure pressure 6,7 .…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the effects of medial saphenous venous pressures as an indirect method of measurement of intra‐abdominal pressures in the horse

Munsterman

Gillen

Coleridge

et al. 2020

J Vet Emergen Crit Care

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Objective: To evaluate the effect of changes in intra-abdominal pressure (IAP) on medial saphenous venous pressure (MSVP) and hemodynamics in normal horses. Design: Experimental, in-vivo study. Setting: University Teaching Hospital. Animals: Convenience sample of 7 mixed breed horses; 5 geldings, and 2 mares. Interventions: Pneumoperitoneum was induced in horses under standing sedation with carbon dioxide gas using a laparoscopic insufflator for a total of 60 minutes to simulate clinical elevation in IAP. Pressure was increased stepwise to 20 mm Hg over 30 minutes, and maintained at that pressure for 30 minutes to evaluate the effect of sustained intra-abdominal hypertension. The MSVP and vital parameters were recorded, along with direct arterial blood pressure from the transverse facial artery. Measurements and Main Results: As IAP increased, MSVP increased in a stepwise manner, in concert with changes in IAP. The consistency in measurement between MSVP and IAP was high (intraclass correlation coefficient = 0.92; P < 0.001) and repeated measures correlation was excellent (r = 0.98; P < 0.001). Heart rate was unchanged over the course of the experiment (P = 0.09), however, respiratory rate increased with increasing IAP (P < 0.001). Arterial blood pressure also increased with insufflation (P < 0.001), with a significant difference at an IAP of 15 mm Hg (P = 0.04). Conclusions: This report provides preliminary data demonstrating a strong correlation between equine MSVP and changes in IAP, similar to that observed in other species. Further investigations are needed to evaluate this relationship, and to confirm these results in clinical patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of the effects of medial saphenous venous pressures as an indirect method of measurement of intra‐abdominal pressures in the horse

Munsterman

Gillen

Coleridge

et al. 2020

J Vet Emergen Crit Care

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“…El síndrome compartimental abdominal generado por hipertensión abdominal en el equino ha sido registrado en casos clínicos con evidentes alteraciones patológicas, clínicas y hemodinámicas (46). Sin embargo, las constantes variaciones en los valores normales de la presión y dificultades en su medida no han permitido su uso en la rutina clínica, a pesar de trabajos desarrollados acerca de la determinación directa e indirecta de la presión abdominal en esta especie (47)(48)(49). Existe evidencia de que la distensión lleva a alteraciones hemodinámicas y vasculares; por lo tanto, sería pertinente el registro de este parámetro en la sumatoria de decisión de los cuadros de cólico.…”

Section: Distensión Abdominalunclassified

Consideraciones para la toma de decisiones oportunas ante el cólico equino: ¿manejo médico o quirúrgico?

2016

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El síndrome de abdomen agudo (SAA) es una condición clínica con fuerte impacto en la sanidad equina, debido a la alta morbimortalidad que lo caracteriza. Múltiples modelos experimentales se han desarrollado para establecer relaciones causales entre la presentación de alteraciones en el abdomen y la severidad del cólico equino. La investigación constantemente intenta crear protocolos de atención oportuna y precisa, con el fin de disminuir la tasa de mortalidad. Estos protocolos buscan reducir las imprecisiones en el plan terapéutico, sobre todo cuando debido a la severidad del síndrome se requiere intervenir quirúrgicamente al equino. Entre los parámetros incluidos en los protocolos de clasificación del SAA o cólico se encuentran biomarcadores de lesión como el lactato, el cortisol, el dímero D, entre otros, y signos clínicos característicos agrupados en tablas de calificación. Los parámetros mayormente asociados con la decisión terapéutica son intensidad del dolor y respuesta a la terapia analgésica, aunque puede acompañarse en orden de sensibilidad, de la auscultación abdominal y palpación transrectal, naturalmente fortalecidos por el examen clínico completo. El uso de tablas de calificación auxilia la atención médica en favor de un abordaje terapéutico rápido y acertado.

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Pathophysiology of intraabdominal hypertension and abdominal compartment syndrome and relevance to veterinary critical care

Gardner

Schroeder

2022

J Vet Emergen Crit Care

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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...

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Alternative Intrabladder Manometry Technique for the Indirect Measurement of Intra-abdominal Pressure in Horses

Cited by 4 publications

References 39 publications

Evaluation of the effects of medial saphenous venous pressures as an indirect method of measurement of intra‐abdominal pressures in the horse

Evaluation of the effects of medial saphenous venous pressures as an indirect method of measurement of intra‐abdominal pressures in the horse

Consideraciones para la toma de decisiones oportunas ante el cólico equino: ¿manejo médico o quirúrgico?

Pathophysiology of intraabdominal hypertension and abdominal compartment syndrome and relevance to veterinary critical care

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