Viabilidade da avaliação indireta das variações da pressão intra-abdominal pela pressão intravesical em cavalos
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Data
2022-05-05
Autores
Paula, Vanessa Barroco de
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Universidade Estadual Paulista (Unesp)
Resumo
Na primeira etapa do estudo verificamos a metodologia desenvolvida (processo FAPESP 2016/00496-4) para validar o registro indireto da pressão intra-abdominal (PIA) nos cavalos, por meio da pressão intravesical (PIV), averiguando também o efeito da distensão vesical sobre a PIV. Após esta confirmação, avaliamos a eficácia da PIV em monitorar as variações pressóricas intra-abdominais frente à distensão cecal controlada e progressiva (etapa II). Para tal, utilizamos oito equinos submetidos à tiflopexia em estudo prévio, com fase experimental concluída (processo FAPESP 2015/24860-4). A mensuração da PIA foi realizada com acesso direto à cavidade abdominal por meio da linha alba. A PIV foi registrada por meio de metodologia previamente descrita pelo próprio grupo de pesquisa, com alterações nos volumes de insuflação vesical (50 mℓ, 100 mℓ, 300 mℓ, até 500 mℓ). Todas as pressões foram mensuradas com uso de coluna de solução salina, em equipo de pressão venosa central (PVC). A hipertensão foi produzida por distensão cecal com solução salina de NaCl 0,9% (incrementos de 5,0 L até 15 L). Para tal, em ambas as etapas do estudo, os cavalos foram mantidos em decúbito lateral esquerdo, mediante anestesia geral inalatória, com ventilação controlada à pressão. Todos os registros pressóricos foram obtidos em centro cirúrgico. Observou-se correlação forte a muito forte para o volume de distensão vesical de 100 mℓ, tanto ao final da inspiração quanto expiração, para ambos os volumes de distensão cecal. Assim como o método padrão para registro da PIA em seres humanos, a PIV também pode ser utilizada nos equinos para o monitoramento da PIA e seus diferenciais pressóricos. Os pacientes devem estar posicionados em decúbito lateral esquerdo, utilizando o volume de preenchimento vesical de 100 mℓ, preferencialmente, de modo que os valores possam ser registrados tanto ao final da inspiração, quanto da expiração.
In the first stage of the study, we verified the methodology developed (FAPESP process 2016/00496-4) to validate the indirect recording of intra-abdominal pressure (IAP) in horses, through intravesical pressure (IPV), also investigating the effect of bladder distention about PIV. After this confirmation, we evaluated the effectiveness of IVP in monitoring intra-abdominal pressure variations in the face of controlled and progressive cecal distention (step II). To this end, we used eight horses submitted to typhlopexia in a previous study, with the experimental phase concluded (FAPESP process 2015/24860-4). The measurement of IAP was performed with direct access to the abdominal cavity through the linea alba. IVP was recorded using a methodology previously described by the research group itself, with changes in bladder insufflation volumes (50 mℓ, 100 mℓ, 300 mℓ, up to 500 mℓ). All pressures were measured using a saline solution column, in a central venous pressure (CVP) device. Hypertension was produced by cecal distention with 0.9% NaCl saline solution (increments from 5.0 L to 15 L). For this purpose, in both stages of the study, the horses were kept in the left lateral decubitus position, under general inhalation anesthesia, with pressure-controlled ventilation. All pressure records were obtained in the operating room. A strong to very strong correlation was observed for the bladder distention volume of 100 mℓ, both at the end of inspiration and expiration, for both volumes of cecal distention. Like the standard method for recording IAP in humans, IVP can also be used in horses to monitor IAP and its pressure differentials. Patients should be positioned in the left lateral decubitus position, using a bladder filling volume of 100 mℓ, preferably, so that the values can be recorded both at the end of inspiration and expiration.
In the first stage of the study, we verified the methodology developed (FAPESP process 2016/00496-4) to validate the indirect recording of intra-abdominal pressure (IAP) in horses, through intravesical pressure (IPV), also investigating the effect of bladder distention about PIV. After this confirmation, we evaluated the effectiveness of IVP in monitoring intra-abdominal pressure variations in the face of controlled and progressive cecal distention (step II). To this end, we used eight horses submitted to typhlopexia in a previous study, with the experimental phase concluded (FAPESP process 2015/24860-4). The measurement of IAP was performed with direct access to the abdominal cavity through the linea alba. IVP was recorded using a methodology previously described by the research group itself, with changes in bladder insufflation volumes (50 mℓ, 100 mℓ, 300 mℓ, up to 500 mℓ). All pressures were measured using a saline solution column, in a central venous pressure (CVP) device. Hypertension was produced by cecal distention with 0.9% NaCl saline solution (increments from 5.0 L to 15 L). For this purpose, in both stages of the study, the horses were kept in the left lateral decubitus position, under general inhalation anesthesia, with pressure-controlled ventilation. All pressure records were obtained in the operating room. A strong to very strong correlation was observed for the bladder distention volume of 100 mℓ, both at the end of inspiration and expiration, for both volumes of cecal distention. Like the standard method for recording IAP in humans, IVP can also be used in horses to monitor IAP and its pressure differentials. Patients should be positioned in the left lateral decubitus position, using a bladder filling volume of 100 mℓ, preferably, so that the values can be recorded both at the end of inspiration and expiration.
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Palavras-chave
Hipertensão intra-abdominal, Equine, Intra-abdominal hypertension, Cavalo