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Splanchnic vasoregulation after major abdominal surgery in pigs
Lukas E Brügger1, Guido Beldi, Mario Beck
1Department of Visceral Surgery and Medicine, Bern University Hospital and University of Bern, 3010 Bern, Switzerland.
World Journal of Surgery
|April 13, 2010
Summary
Abdominal surgery can cause intestinal hypoperfusion due to blood flow redistribution, even when blood volume is normal. This study in pigs shows reduced mesenteric artery flow post-surgery, highlighting risks despite maintaining normovolemia.
Area of Science:
- Physiology
- Surgical Research
- Hemodynamics
Background:
- Reduced intestinal blood supply (hypoperfusion) is a major cause of complications after abdominal surgery.
- The study investigates if blood flow redistribution, not just low blood volume, causes intestinal hypoperfusion post-abdominal surgery.
Purpose of the Study:
- To determine if intestinal hypoperfusion occurs due to blood flow redistribution after abdominal surgery, independent of hypovolemia.
- To quantify changes in systemic, regional, and local blood flow in response to operative trauma.
Main Methods:
- Operative trauma was induced in 14 healthy pigs.
- Systemic, regional, and local blood flow, along with mucosal perfusion indicators (pCO2 gradients), were measured for 10 hours post-surgery.
- Normovolemia was maintained using fluid infusions and boluses guided by hemodynamic parameters.
Main Results:
- Postoperative blood flow increased significantly in the celiac trunk (76%), hepatic artery (136%), and splenic artery (36%).
- Mesenteric artery blood flow decreased by 25% and portal vein flow by 13%.
- Carotid and renal artery blood flow remained unchanged.
Conclusions:
- Maintaining normal blood volume (normovolemia) is insufficient to prevent intestinal hypoperfusion after abdominal surgery.
- Cardiac output redistribution post-surgery leads to decreased intestinal blood flow and increased flow to the liver and spleen.
