Treatment of Intracranial Hypertension Using Nonsurgical Abdominal Decompression

Abstract

Elevated intra-abdominal pressure (IAP) increases intracranial pressure (ICP) and reduces cerebral perfusion pressure (CPP). We evaluated a nonsurgical means of reducing IAP to reverse this process. Swine with a baseline ICP of 25 mm Hg produced by an intracranial balloon catheter were studied. In group 1 (n = 5), IAP was increased by 25 mm Hg. Continuous negative abdominal pressure (CNAP) was then applied. Group 2 (n = 4) had neither IAP elevation nor CNAP. Group 3 (n = 4) had CNAP without IAP elevation. Elevation of IAP by 25 mm Hg above baseline led to deleterious changes in ICP (25.8 +/- 0.8 to 39.0 +/- 2.8; p 0.05) and CPP (80.8 +/- 1.4 to 80.5 +/- 1.8; p > 0.05). In group 3, CNAP decreased cardiac index (2.9 +/- 0.2 to 1.1 +/- 0.4; p Elevations in IAP led to increased ICP and decreased CPP. CNAP ameliorated these intracranial disturbances. With normal IAP, CNAP impaired cerebral perfusion.