RESUMO
BACKGROUND: Ventilation of an unprotected airway may result in stomach inflation. The purpose of this study was to evaluate the effect of clinically realistic stomach inflation on cardiopulmonary function during hemorrhagic shock in a porcine model. METHODS: Pigs were randomized to a sham control group (nâ=â9), hemorrhagic shock (35âmLâkg over 15âmin [nâ=â9]), and hemorrhagic shock combined with stomach inflation (35âmLâkg over 15âmin and 5âL stomach inflation [nâ=â10]). RESULTS: When compared with the control group, hemorrhagic shock (nâ=â9) increased heart rate (103â±â11 vs. 146â±â37âbeatsâmin; Pâ=â0.002) and lactate (1.4â±â0.5 vs. 4.0â±â1.9âmmolâL; Pâ<â0.001), and decreased mean arterial blood pressure (81.3â±â12.8 vs. 35.4â±â8.1âmmHg; Pâ<â0.001) and stroke-volume index (38.1â±â6.4 vs. 13.6â±â4.8âmLâminâm; Pâ<â0.001). Hemorrhagic shock combined with stomach inflation (nâ=â10) versus hemorrhagic shock only (nâ=â9) increased intra-abdominal pressure (27.0â±â9.3 vs. 1.1â±â1.0âmmHg; Pâ<â0.001), and decreased stroke-volume index (9.9â±â6.0 vs. 20.8â±â8.5âmLâminâm; Pâ=â0.007), and dynamic respiratory system compliance (10.8â±â4.5 vs. 38.1â±â6.1âmLâcmH2O; Pâ<â0.001). Before versus after stomach evacuation during hemorrhagic shock, intra-abdominal pressure decreased (27.0â±â9.3 vs. 9.8â±â5.4âmmHg; Pâ=â0.042). Survival in the sham control and hemorrhagic shock group was 9 of 9, respectively, and 3 of 10 after hemorrhagic shock and stomach inflation (Pâ<â0.001). CONCLUSIONS: During hemorrhagic shock stomach inflation caused an abdominal compartment syndrome and thereby impaired cardiopulmonary function and aerobic metabolism, and increased mortality. Subsequent stomach evacuation partly reversed adverse stomach-inflation triggered effects.
