• T M Hörer, P Skoog, L Norgren, A Magnuson, L Berggren, K Jansson, and T Larzon.
• Department of Cardio-Thoracic and Vascular Surgery, Örebro University Hospital and Örebro University, Örebro, Sweden. tal.horer@orebroll.se
• Eur J Vasc Endovasc Surg. 2013 Jun 1;45(6):596-606.

ObjectivesThis study aims to evaluate intra-peritoneal (ip) microdialysis after endovascular aortic repair (EVAR) of ruptured abdominal aortic aneurysm (rAAA) in patients developing intra-abdominal hypertension (IAH), requiring abdominal decompression.DesignProspective study.Material And MethodsA total of 16 patients with rAAA treated with an emergency EVAR were followed up hourly for intra-abdominal pressure (IAP), urine production and ip lactate, pyruvate, glycerol and glucose by microdialysis, analysed only at the end of the study. Abdominal decompression was performed on clinical criteria, and decompressed (D) and non-decompressed (ND) patients were compared.ResultsThe ip lactate/pyruvate (l/p) ratio was higher in the D group than in the ND group during the first five postoperative hours (mean 20 vs. 12), p = 0.005 and at 1 h prior to decompression compared to the fifth hour in the ND group (24 vs. 13), p = 0.016. Glycerol levels were higher in the D group during the first postoperative hours (mean 274.6 vs. 121.7 μM), p = 0.022. The IAP was higher only at 1 h prior to decompression in the D group compared to the ND group at the fifth hour (mean 19 vs. 14 mmHg).ConclusionsIp l/p ratio and glycerol levels are elevated immediately postoperatively in patients developing IAH leading to organ failure and subsequent abdominal decompression.Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

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