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June 1967

Inferior Vena Caval Obstruction From Increased Intra-abdominal Pressure: Experimental Hemodynamic and Angiographic Observations

Author Affiliations

Bethesda, Md
From the Clinic of Surgery, National Heart Institute, and Diagnostic Radiology Department, Clinical Center, National Institutes of Health, Bethesda.

Arch Surg. 1967;94(6):766-770. doi:10.1001/archsurg.1967.01330120020005

IT HAS recently been demonstrated that partial obstruction of the suprahepatic segment of the abdominal inferior vena cava may accompany abdominal ascites in patients with cirrhosis or severe congestive heart failure.1 Doppman and others reproduced this unusual form of vena caval obstruction in experimental animals and demonstrated that the narrowing resulted from increased intra-abdominal pressure and was the result of physical forces acting on the collapsible venous segment at its site of exit from the abdomen.2 The precise hemodynamic consequences of this functional form of vena caval obstruction have not, however, been previously determined. In the present experiments, the effects of graded increases in intra-abdominal pressure on pressure and flow in the inferior vena cava were studied in the dog.

Methods  Twelve mongrel dogs, ranging in weight from 14 to 20 kg, were anesthetized with sodium pentobarbital administered intravenously (35 mg/kg) and ventilated with a volume-controlled respirator supplying