Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Ischemia as a possible effect of increased intraabdominal pressure on central nervous system cytokines, lactate and perfusion pressures. | Marinis et al. Critical Care 2010 14 R31 http content 14 2 R31 c CRITICAL CARE RESEARCH Open Access Ischemia as a possible effect of increased intraabdominal pressure on central nervous system cytokines lactate and perfusion pressures 1 2 1 1 2 Athanasios Marinis Eriphili Argyra Pavlos Lykoudis Paraskevas Brestas Kassiani Theodoraki Georgios Polymeneas1 Efstathios Boviatsis3 Dionysios Voros1 Abstract Introduction The aims of our study were to evaluate the impact of increased intra-abdominal pressure IAP on central nervous system CNS cytokines Interleukin 6 and tumor necrosis factor lactate and perfusion pressures testing the hypothesis that intra-abdominal hypertension IAH may possibly lead to CNS ischemia. Methods Fifteen pigs were studied. Helium pneumoperitoneum was established and IAP was increased initially at 20 mmHg and subsequently at 45 mmHg which was finally followed by abdominal desufflation. Interleukin 6 IL-6 tumor necrosis factor alpha TNFa and lactate were measured in the cerebrospinal fluid CSF and intracranial ICP intraspinal ISP cerebral perfusion CPP and spinal perfusion SPP pressures recorded. Results Increased IAP 20 mmHg was followed by a statistically significant increase in IL-6 p lactate p ICP p and ISP p and a significant decrease in CPP p and SPP p . However further increase of IAP 45 mmHg was accompanied by an increase in mean arterial pressure due to compensatory tachycardia followed by an increase in CPP and SPP and a decrease of cytokines and lactate. Conclusions IAH resulted in a decrease of CPP and SPP lower than 60 mmHg and an increase of all ischemic mediators indicating CNS ischemia on the other hand restoration of perfusion pressures above this threshold decreased all ischemic indicators irrespective of the level of IAH. Introduction Intra-abdominal hypertension IAH and abdominal compartment syndrome ACS are two clinical entities constituting a continuum of pathophysiologic .
