HIGH INTRAABDOMINAL PRESSURE - EFFECTS ON CLINICAL-PARAMETERS AND LUNG PATHOLOGY IN BABOONS (PAPIO-CYNOCEPHALUS AND PAPIO-ANUBIS)

OBJECTIVE: The risks of a high intraabdominal pressure during laparosc opy are poorly documented. These aspects were studied in a relevant no nhuman primate model, the baboon (Papio anubis, Papio cynocephalus). S TUDY DESIGN: The animals used were to be killed at the completion of a vaccine project. They were anesthetized and intubated but allowed to breathe spontaneously. In group 1 (n = 10) a fixed intraabdominal pres sure (between 10 and 35 cm H2O [7 and 26 mm Hg]) was applied over 30 m inutes. In group 2 (n = 7) the intraabdominal pressure was increased u p to a maximum of 105 cm H2O (77 mm Hg). Blood vessels of the parietal peritoneum and omentum were systematically opened from 30 cm H2O (22 mm Hg) onward. Respiration and pulse rate were measured regularly, and the degree of respiratory distress was assessed. After death of the b aboons a necropsy was carried out immediately to study the degree of l ung atelectasis. RESULTS: In group 1 the respiration rate increased an d the heart rate decreased. At an intraabdominal pressure of greater-t han-or-equal-to 30 cm H2O (22 mm Hg) moderate respiratory distress was seen after 20 minutes. In group 2 one animal had a bilateral pneumoth orax at a pressure of 60 cm H2O (44 mm Hg) and died at 90 cm H2O (66 m m Hg). Severe respiratory distress was observed in the other six anima ls. Severe lung atelectasis was present in only one of the five primat es with moderate respiratory distress of group 1 and in all baboons of group 2. CONCLUSION: An increase of intraabdominal pressure up to 105 cm H2O (77 mm Hg) combined with intraabdominal blood vessel injury is not lethal in most baboons.