Author/Editor		Gadžijev, EM; Stanisavljevič, D; Mimica, Z; Wahl, M; Butinar, J; Tomažič, A
Title		Can we evalute the pressure of perihepatic packing? Results of a study on dogs
Type		članek
Source		Injury
Vol. and No.		Letnik 30
Publication year		1999
Volume		str. 35-41
Language		eng
Abstract		The pressure of perihepatic packing can cause organ perfusion disturbances. The problem is to determine the pressure applied during the operative procedure. The objective of this animal study was to assess the perihepatic packing pressure and its effect onthe pressure in the inferior vena cava (IVC). In order to assess the pressure in the IVC a catheter was introduced through the femoral vein. A rearranged tourniquet for blood pressure measurement was placed on the dog liver and with various perihepatic pressures the resulting pressures in the IVC were assessed. It was established, that by applying pressure of 30 mm Hg to the liver, the pressure in the IVC did not exceed 10 cm of water. Two clinical cases are reported where the method was shown to be crucial for the management. The first one is related to haemodynamic instability after successful perihepatic packing for grade V injury. In the second case, an otherwise stable patient had significantly elevated pressure in the IVC, which crucially influenced the treatment. The introduction of a catheter into the IVC to monitor the pressure in patients with liver injuries is useful.
Descriptors		LIVER VENA CAVA, INFERIOR CATHETERIZATION, PERIPHERAL PRESSURE BLOOD PRESSURE DOGS CENTRAL VENOUS PRESSURE LAPAROTOMY HEMODYNAMICS