Changes in intra-abdominal pressure and central venous and brain venous blood pressure in patients during extracorporeal circulation. 2007

Wojciech Dabrowski
Department of Anesthesiology and Intensive Therapy, Feliks Skubiszewski Medical University of Lublin, Poland. wojciechdabrowski@interia.pl

BACKGROUND The aim was to analyze IAP changes and the relationships between IAP, CVP, and brain venous blood pressure, which are still unknown, in patients undergoing coronary artery bypass grafting (CABG) with extracorporeal circulation. METHODS Twenty-five male patients (aged 53-67 years) underwent CABG under general anesthesia with normovolemic hemodilution. IAPs were measured in the urinary bladder, CVP by left internal jugular vein cannulation, and brain venous blood pressure by retrograde cannulation of the right jugular vein bulb (JVP, jugular vein pressure) at seven time-points: 1) after induction of anesthesia before the operation, 2) during internal thoracic artery preparation, 3) 10 minutes after heart-lung machine disconnection, 4) after procedure completion, before sending the patient to the intensive postoperative care unit, 5) one hour after the procedure, 6) 6 hours after the procedure, and 7) 18 hours after the procedure. RESULTS IAP increased from points 3 to 6. CVP increased from points 3, 4, and 5 and decreased at point 7. Similar changes were noted in JVP. There were significant correlations between IAP and CVP at points 1, 2, 3, 4, and 5, IAP and JVP at points 3, 4, and 5, and CVP and JVP at all points. The overall analysis showed correlations between IAP and CVP and JVP and very strong correlation between CVP and JVP. CONCLUSIONS 1) CABG with extracorporeal circulation resulted in increases in IAP, CVP, and brain venous blood pressure. 2) The changes in CVP and brain venous blood pressure correlated with intra-abdominal pressure.

UI MeSH Term Description Entries
D008297 Male Males
D011312 Pressure A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Pressures
D001743 Urinary Bladder A musculomembranous sac along the URINARY TRACT. URINE flows from the KIDNEYS into the bladder via the ureters (URETER), and is held there until URINATION. Bladder,Bladder Detrusor Muscle,Detrusor Urinae,Bladder Detrusor Muscles,Bladder, Urinary,Detrusor Muscle, Bladder,Detrusor Muscles, Bladder
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D002496 Central Venous Pressure The blood pressure in the central large VEINS of the body. It is distinguished from peripheral venous pressure which occurs in an extremity. Venous Pressure, Central,Central Venous Pressures,Pressure, Central Venous,Pressures, Central Venous,Venous Pressures, Central
D005112 Extracorporeal Circulation Diversion of blood flow through a circuit located outside the body but continuous with the bodily circulation. Circulation, Extracorporeal,Circulations, Extracorporeal,Extracorporeal Circulations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000005 Abdomen That portion of the body that lies between the THORAX and the PELVIS. Abdomens
D001026 Coronary Artery Bypass Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. Aortocoronary Bypass,Bypass, Coronary Artery,Bypass Surgery, Coronary Artery,Coronary Artery Bypass Grafting,Coronary Artery Bypass Surgery,Aortocoronary Bypasses,Artery Bypass, Coronary,Artery Bypasses, Coronary,Bypass, Aortocoronary,Bypasses, Aortocoronary,Bypasses, Coronary Artery,Coronary Artery Bypasses
D014690 Venous Pressure The blood pressure in the VEINS. It is usually measured to assess the filling PRESSURE to the HEART VENTRICLE. Blood Pressure, Venous,Blood Pressures, Venous,Pressure, Venous,Pressure, Venous Blood,Pressures, Venous,Pressures, Venous Blood,Venous Blood Pressure,Venous Blood Pressures,Venous Pressures

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