Zmiany ciśnienia śródbrzusznego u chorych poddanych chirurgicznej rewaskularyzacji mięśnia sercowego

*Wojciech Dąbrowski

Summary
Background. Increased intra-abdominal pressure (IAP) may play an important role in pathophysiology related to surgery performed under extracorporeal circulation (ECC), especially when intra-abdominal compartment syndrome occurs. Causes of IAP increases are not well defined, and haemodilution may contribute. Changes in IAP were assessed during CABG surgery under extracorporeal circulation.
Methods. The study was conducted in 25 male patients, aged 53-67 years, scheduled for elective CABG surgery. Bladder pressure was measured via a Foley catheter: 1) after induction of anaesthesia; 2) at the start of ECC; 3) after weaning from the ECC; 4) immediately before transportation to the PITU; 5) one hour after surgery; 6) six hours after surgery; and 7) 18 hours after surgery.
Results. The mean duration of anaesthesia was 225.1±26.0 min, and the mean duration of ECC was 96.6±22.7 min. IAP increased at the 3^rd, 4^th, 5^th and 6^th measuring points and returned to normal 18 hours after surgery. No complications occurred.
Discussion. The most probable reason for the increased IAP during ECC is normovolaemic haemodilution causing intestinal oedema and capillary leakage. Postoperative crystalloid infusion did not increase IAP.

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