Síndrome compartimental abdominal: análise do conhecimento da equipe médica de um Hospital Universitário de Curitiba

Bahten, Luiz Carlos Von; Lange, Paulo Afonso Lopes; Alves, Renan Fernando Ferreira; Soares, Herick Muniz Nequer; Souza, Thiago Magalhães de; Bahten, Aline Cadena Von

doi:10.1590/0100-6991e-20181884

Cited by 5 publications

(9 citation statements)

References 12 publications

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“…However, most of these articles bring the treatment of each system in isolation, not establishing a correlation in which the excessive increase in IAP can increase the increase in ICP, which, in turn, causes neurological damage that is often irreversible. 2,4,7 The literature shows us that acute IAH)causes an increase in ICP due to increased pleural pressure, thus preventing venous return. The increase in chest pressure leads to an increase in central venous pressure (CVP), which increases the intrajugular pressure, consequently decreasing the venous return of the brain and increasing, even more, the ICP.…”

Section: Discussionmentioning

confidence: 99%

“…The physiological value in adults is up to 5 mm Hg; however, in patients with altered conditions without pathophysiological significance, such as obese individuals, it can range from 10 to 15 mm Hg; in critically ill patients, it is considered between 5 to 7 mm Hg. [3][4][5][6] Intra-abdominal hypertension (IAH) is considered when an increased IAP (> 12 mm Hg) is registered after three measurements at intervals of between 4 and 6 hours. Since it is gradual, it can progress to abdominal compartment syndrome (ACS), when IAP is maintained at levels higher than 20 mm Hg, associated with changes or organ failure.…”

Section: Introductionmentioning

confidence: 99%

“…Since it is gradual, it can progress to abdominal compartment syndrome (ACS), when IAP is maintained at levels higher than 20 mm Hg, associated with changes or organ failure. 4,6 This topic was chosen because, despite all the available technology that is applied to care within an intensive care unit, several times, we come across this environment with patients presenting multisystemic aggravations. Among them, head and abdominal trauma and many times, these patients are in clinical condition with a progressive increase in ICP, which does not decrease with either surgical intervention or pharmacological measures (sedation with neuromuscular blocker associated with osmotic diuretics).…”

Section: Introductionmentioning

confidence: 99%

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Intracranial Hypertension and Intra-abdominal Pressure. Is it Worth Measuring?

Bonatto

Matias

Welling

2020

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Patients with refractory intracranial hypertension who have already undergone all the measures recommended by the current guidelines can benefit from having their intra-abdominal pressure monitored since its increase generates hemodynamic repercussions and secondary elevation of intracranial pressure. In this context, a bibliographic research was performed on PubMed with the terms intra-abdominal pressure, abdominal compartment syndrome, intracranial pressure, intracranial hypertension. Altogether, 146 articles were observed, 87 of which were from the year 2000, and only 15 articles were considered relevant to the topic. These studies indicate that patients with refractory intracranial hypertension can benefit from the measurement of intraabdominal pressure, since there is evidence that an increase in this pressure leads to organic dysfunctions with an indirect impact on cerebral venous return and, consequently, an increase in intracranial pressure. In those who underwent decompression laparotomy, direct effects were observed in reducing intracranial hypertension and survival.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intracranial Hypertension and Intra-abdominal Pressure. Is it Worth Measuring?

Bonatto

Matias

Welling

2020

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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“…Brazilian College of Surgeons 1 . It pleased me much to read this article, even more so by seeing this topic published in a journal for surgeons.…”

mentioning

confidence: 99%

“…The authors demonstrated that although most of the physicians who answered the questionnaire stated that they were familiar with IAH and ACS, knowledge is incoherent and inadequate about the definitions published in the consensus of the World Society of the Abdominal Compartment (WSACS), the clinical measurement, and the treatment techniques. VonBathen et al1 sought to study exactly this awareness.…”

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confidence: 99%

Síndrome compartimental abdominal: relevância imensurável.

Pereira

2019

Rev. Col. Bras. Cir.

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Intra-abdominal hypertension and abdominal compartment syndrome in patients admitted to the ICU

Smit

Koopman

Dieperink

et al. 2020

Ann. Intensive Care

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Background Intra-abdominal hypertension is frequently present in critically ill patients and is an independent predictor for mortality. Risk factors for intra-abdominal hypertension and abdominal compartment syndrome have been widely investigated. However, data are lacking on prevalence and outcome in high-risk patients. Our objectives in this study were to investigate prevalence and outcome of intra-abdominal hypertension and abdominal compartment syndrome in high-risk patients in a prospective, observational, single-center cohort study. Results Between March 2014 and March 2016, we included 503 patients, 307 males (61%) and 196 females (39%). Patients admitted to the intensive care unit with a diagnosis of pancreatitis, elective or emergency open abdominal aorta surgery, orthotopic liver transplantation, other elective or emergency major abdominal surgery and trauma were enrolled. One hundred and sixty four (33%) patients developed intra-abdominal hypertension and 18 (3.6%) patients developed abdominal compartment syndrome. Highest prevalence of abdominal compartment syndrome occurred in pancreatitis (57%) followed by orthotopic liver transplantation (7%) and abdominal aorta surgery (5%). Length of intensive care stay increased by a factor 4 in patients with intra-abdominal hypertension and a factor 9 in abdominal compartment syndrome, compared to patients with normal intra-abdominal pressure. Rate of renal replacement therapy was higher in abdominal compartment syndrome (38.9%) and intra-abdominal hypertension (8.2%) compared to patients with normal intra-abdominal pressure (1.2%). Both intensive care mortality and 90-day mortality were significantly higher in intra-abdominal hypertension (4.8% and 15.2%) and abdominal compartment syndrome (16.7% and 38.9%) compared to normal intra-abdominal pressure (1.2% and 7.1%). Body mass index (odds ratio 1.08, 95% confidence interval 1.03–1.13), mechanical ventilation at admission (OR 3.52, 95% CI 2.08–5.96) and Apache IV score (OR 1.03, 95% CI 1.02–1.04) were independent risk factors for the development of intra-abdominal hypertension or abdominal compartment syndrome. Conclusions The prevalence of abdominal compartment syndrome was 3.6% and the prevalence of intra-abdominal hypertension was 33% in this cohort of high-risk patients. Morbidity and mortality increased when intra-abdominal hypertension or abdominal compartment syndrome was present. The patient most at risk of IAH or ACS in this high-risk cohort has a BMI > 30 kg/m2 and was admitted to the ICU after emergency abdominal surgery or with a diagnosis of pancreatitis.

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Síndrome compartimental abdominal: análise do conhecimento da equipe médica de um Hospital Universitário de Curitiba

Abstract: half of the physicians were able to classify intra-abdominal hypertension and indicate the onset of abdominal compartment syndrome correctly.

Cited by 5 publications

References 12 publications

Intracranial Hypertension and Intra-abdominal Pressure. Is it Worth Measuring?

Intracranial Hypertension and Intra-abdominal Pressure. Is it Worth Measuring?

Síndrome compartimental abdominal: relevância imensurável.

Intra-abdominal hypertension and abdominal compartment syndrome in patients admitted to the ICU

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