Hemorheological factors can be informative in comparing treatment possibilities of abdominal compartment syndrome

Background: Abdominal compartment syndrome (ACS) is a life-threatening condition, of which pathomechanism hasn't been completely clarified, yet. Furthermore, surgical therapy still needs optimization.

Objective: We aimed to investigate microcirculatory and micro-rheological alterations in ACS, using various temporary abdominal closure methods, including three settings of vacuum-assisted closure technique (negative pressure wound therapy, NPWT).

Methods: On anesthetized pigs, by intraabdominally placed and filled-up silicone bags, intraabdominal pressure at 30 mmHg was maintained for 3 hours, and afterwards, decompressive laparotomy happened. In different experimental groups Bogota-bag or Vivano abdominal sets were applied (-50, -100, -150 mmHg) for 2 hours. Pressure monitoring was done by implanted sensors, hemorheological parameters were determined, and laser Doppler flowmetry tests were performed on the surface of intraabdominal organs.

Results: Treatment with Bogota-bag and -150 mmHg vacuum increased erythrocyte aggregation, while deformability declined. Blood viscosity increased after treatment with -150 mmHg vacuum. The microcirculatory parameters of the NPWT groups were better in small intestine.

Conclusions: ACS resulted in impairment of macro- and micro-rheological parameters and abdominal organs' microcirculation. All of the used techniques improved the results, however, applying Bogota-bag or -150 mmHg vacuum set showed worse microcirculatory and micro-rheological data than the settings at -100 or -50 mmHg.