Author/Editor		Gadžijev, EM; Stanisavljević, D; Wahl, M; Butinar, J; Pegan, V; Trotovšek, B
Title		Measuring the pressure in the inferior vena cava gives important information for the treatment of liver injury
Type		članek
Source		In: Broelsch CE, Izbicki JR, Bloechle C, et al, editors. European IHPBA congress Hamburg '97; 1997 Jun 8-12; Hamburg. Bologna: Monduzzi editore,
Publication year		1997
Volume		str. 173-7
Language		eng
Abstract		Perihepatic packing can cause organ perfusion problems and abdominal compartment syndrome. A study on animal models is presented in which we wished to evaluate the quantity of perihepatic packing pressure. The pressure in the inferior vena cava (IVC) was measured using a catheter introduced over the femoral vein. Technical accomplishment of experiments, the results of measurements and their evaluation are shown. Based on the experimental data we introduced the method into clinical practice. Two impressive cases are reported where the method had been shown to be of crucial importance for the management of injured patients. The first is a case of haemodinamic instability after succesful perihepatic packing for grade V injury where insertion of the catheter into IVC showed the reason of the complication. The patient was forthwith reoperated and repacked without consequences to the kidneys. In the second case a catheter was introduced into IVC in an injured adolescent whom we had planned to treat conservatively. The pressure raised up to 40 cm of water and the otherwise stable patient was operated upon. The raised pressure was caused by huge central liver hematoma which expanded into retroperitoneal space producing compression of IVC and duodenum, explaining at the same time the patient vomiting. Local hemostasis and mesh wrapping were performed. In both cases the postoperative courses were uneventful. We concluded that introducing a catheter into IVC to control the pressure and monitor the patients with liver injuries is a simple and advisable method helping in decisions for treatment as well as to control the effects of perihepatic pressure and to prevent the abdominal compartment syndrome.
Descriptors		VENA CAVA, INFERIOR BLOOD PRESSURE LIVER HEART ATRIUM CENTRAL VENOUS PRESSURE DOGS