Pressure-volume (p-v) relationships (or """"""""compliance curves"""""""") obtained during colonic balloon distention are used to assess drug effects. P-v curves are also applied to characterize biomechanical properties such as viscoelasticity. This is possible if the experimental conditions are consistent with the assumptions of biophysical models.
Our aims were: i) To demonstrate that the deforming stress (i.e. intraballoon pressure) and tissue tension (represented by balloon volume) are in equilibrium (or """"""""steady state"""""""") during colonic balloon distention in humans; to assess ii) the intraindividual reproducibility of p-v relationships, iii) the effect of altering the rate of inflation on p-v curves and iv) differences between ascending (Asc) and descending (Des) p-v curves, i.e. hysteresis. Methods: A barostat-balloon was positioned in the cleansed descending colon in 15 healthy volunteers. During each p-v curve, the barostat balloon was inflated (Asc curve) and subsequently deflated (Des curve) in 4 mmHg steps from 0-44 mmHg. At each step, balloon pressure was maintained until balloon volume stabilized, i.e. fluctuation <10% over 30 seconds, subject to a maximum duration of 5 min for Pr 24 mmHg, 2.5 min for 28-44 mmHg. Four p-v curves at different distention rates (10, 30, 30 and 60 ml/second) were performed in randomized order in each subject. Analysis: The variability in balloon volume at any given pressure was used to determine if """"""""steady state"""""""" was achieved. Results: Balloon volume reached """"""""steady state"""""""" at 2 minutes of beginning distention at each pressure step, i.e. variability (CV%) 10% (at 2 min) for Pr 16mmHg and <5% (at 1 min) for Pr 20 mmHg. Asc and Des curves were reproducible within subjects. Asc and Des curves were significantly different indicating hysteresis. Order of distention did not significantly influence p-v curves. Coefficient of variation (CV%) between subjects denoted in parentheses p<0.05; p <0.01 (paired test: Asc vs. Des) Conclusions: Colonic balloon volume reaches """"""""steady-state"""""""" during assessment of p-v relationships in humans. P-v relationships are reproducible within individuals, demonstrate modest interindividual variability and the phenomenon of hysteresis.
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