METHODS: We performed a study in 21 pigs applying a model of sepsis based on ischemia/reperfusion and fecal spread into the peritoneum. The pigs were randomized into three groups, and treated for 6 h as follows: Group A: temporary abdominal closure with ABTHERA™ Open Abdomen Negative-Pressure Therapy; Group B: temporary abdominal closure with ABTHERA™ Open Abdomen Negative-Pressure Therapy plus abdominal instillation with physiological saline solution (PSS); and Group C: temporary abdominal closure with ABTHERA™ Open Abdomen Negative-Pressure Therapy plus peritoneal instillation with a solution of ropivacaine in PPS.
RESULTS: A comparison between the three groups revealed no statistically significant difference for any of the parameters registered (p > 0.05), i.e., intra-abdominal pressure, blood pressure, heart rate, O2 saturation, diuresis, body temperature, and blood levels of interleukin 6 (IL-6), tumor necrosis factor alpha (TNFα), and c-reactive protein (CRP). In addition, histological studies of the liver, ileum, kidney and lung showed no difference between groups.
CONCLUSIONS: The use of abdominal instillation (with or without ropivacaine) did not change the effect of 6 h of NPT after sepsis in animals with open abdomen. The absence of adverse effects suggests that longer treatments should be tested.
方法:我们在21头猪中进行了一项研究,该研究应用了基于缺血/再灌注和粪便扩散到腹膜中的脓毒症模型。将猪随机分为三组,并治疗6小时,如下:A组:ABTHERA™开腹负压疗法的临时腹部闭合;B组:ABTHERA™开腹负压疗法的临时腹部闭合加生理盐水溶液(PSS)的腹腔滴注;C组:ABTHERA™开腹负压疗法的临时腹部闭合加腹膜滴注罗哌卡因溶液的PPS。
结果:三组之间的比较显示,所记录的任何参数均无统计学意义(p>0.05),即,腹内压,血压,心率,O2饱和度,利尿,体温,和白细胞介素6(IL-6)的血液水平,肿瘤坏死因子α(TNFα),和C反应蛋白(CRP)。此外,肝脏的组织学研究,回肠,肾和肺两组间无差异。
结论:在腹部开放的动物中,使用腹部滴注(有或没有罗哌卡因)不会改变脓毒症后6小时NPT的效果。没有不良反应表明应该测试更长的治疗。