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Malbrain, Manu L N G; Deeren, Dries

doi:10.1186/cc4962

Cited by 100 publications

(22 citation statements)

References 11 publications

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“…With respect to the effect of instillation volume on intra-bladder pressure as an estimation of IAP, large volumes of saline, as much as 100 to 250 ml, may lead to the overestimation of IAP (Malbrain and Deeren, 2006;Vallee et al, 2010), while a minimal volume as low as 2 to 10 ml is sufficient for the IAP signal transduction de Laet et al, 2008b). In terms of zero reference points for IAP measurement, various levels have been suggested such as the symphysis pubis, the phlebostatic axis, and the midaxillary line, each of which may result in different IAP measurements within the same patient.…”

Section: Discussionmentioning

confidence: 99%

Current recognition and management of intra-abdominal hypertension and abdominal compartment syndrome among tertiary Chinese intensive care physicians

Zhou

Zhao

Pan

et al. 2011

J. Zhejiang Univ. Sci. B

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This survey was designed to clarify the current understanding and clinical management of intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS) among intensive care physicians in tertiary Chinese hospitals. A postal twenty-question questionnaire was sent to 141 physicians in different intensive care units (ICUs). A total of 108 (76.6%) questionnaires were returned. Among these, three quarters worked in combined medical-surgical ICUs and nearly 80% had primary training in internal or emergency medicine. Average ICU beds, annual admission, ICU length of stay, acute physiology and chronic health evaluation (APACHE) II score, and mortality were 18.2 beds, 764.5 cases, 8.3 d, 19.4, and 21.1%, respectively. Of the respondents, 30.6% never measured intra-abdominal pressure (IAP). Although the vast majority of the ICUs adopted the exclusively transvesicular method, the overwhelming majority (88.0%) only measured IAP when there was a clinical suspicion of IAH/ACS and only 29.3% measured either often or routinely. Moreover, 84.0% used the wrong priming saline volume while 88.0% zeroed at reference points which were not in consistence with the standard method for IAP monitoring recommended by the World Society of Abdominal Compartment Syndrome. ACS was suspected mainly when there was a distended abdomen (92%), worsening oliguria (80%), and increased ventilatory support requirement (68%). Common causes for IAH/ACS were "third-spacing from massive volume resuscitation in different settings" (88%), "intra-abdominal bleeding", and "liver failure with ascites" (52% for both). Though 60% respondents would recommend surgical decompression when the IAP exceeded 25 mmHg, accompanied by signs of organ dysfunction, nearly three quarters of respondents preferred diuresis and dialysis. A total of 68% of respondents would recommend paracentesis in the treatment for ACS. In conclusion, urgent systematic education is absolutely necessary for most intensive care physicians in China to help to establish clear diagnostic criteria and appropriate management for these common, but life-threatening, diseases.

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Section: Discussionmentioning

confidence: 99%

Current recognition and management of intra-abdominal hypertension and abdominal compartment syndrome among tertiary Chinese intensive care physicians

Zhou

Zhao

Pan

et al. 2011

J. Zhejiang Univ. Sci. B

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“…(8,10,13,16,18,25,26) A prospective study involving 13 intensive care unit (ICUs) in Belgium, Austria, Israel, Brazil and Australia reported IAH and ACS prevalence of 32.1% and 4.2%, respectively, upon patient admission. (5,16) A second study revealed significantly higher mortality indices in critically ill patients presenting with increased IAP compared to unaffected patients (37.9% and 19.1% respectively).…”

Section: Discussionmentioning

confidence: 99%

“…(16,26,27) Clinical presentation generally includes a tense, distended abdomen, hypotension, high airway pressure, hypercapnia and oliguria. (25) …”

Section: Discussionmentioning

confidence: 99%

“…(8,11–13,17,18,20,27) Therefore, multidisciplinary team members must be aware of proper IAP measurement techniques for correct diagnosis and management of IAH patients. (8,12,26) Inaccurate IAP measurements or failure to convert values given in cmH 2 O into mmHg may translate into incorrect indications for surgical abdominal decompression, with increased complication risks for patients. Also, erroneous recognition of IAH as the cause of the patient's condition may lead to changes in support treatment and ventilation parameters, or mislead physicians into ruling out other diagnostic possibilities.…”

Section: Discussionmentioning

confidence: 99%

“…(5,8,10,18,26,27) However, regardless of wide intravesical IAP measurement acceptance, instillation volumes have not been standardized and may range from 50 to 300ml. (10,18,26) In one study testing different instillation volumes (Chart 2), high volumes were associated with high IAP values; overestimation was thought to result from increased intrinsic pressure, in contrast with data given by Kron et al (29) Pressure elevation was already relevant at the 25mL level, but acquired statistical significance from 75mL in most patients. Given the lack of robust data, the authors of that study suggested maximal instillation volumes of 25mL would be enough to create a fluid column and remove air.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Intra-abdominal pressure: an integrative review

Milanesi

Caregnato

2016

Einstein (São Paulo)

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There is a growing request for measuring intra-abdominal pressure in critically ill patients with acute abdominal pain to be clarified. Summarizing the research results on measurement of vesical intra-abdominal pressure and analyzing the level of evidence were the purposes of this integrative literature review, carried out based on the databases LILACS, MEDLINE and PubMed, from 2005 to July 2012. Twenty articles were identified, in that, 12 literature reviews, 4 descriptive and exploratory studies, 2 expert opinions, one prospective cohort study and one was an experience report. The vesical intra-abdominal pressure measurement was considered gold standard. There are variations in the technique however, but some common points were identified: complete supine position, in absence of abdominal contracture, in the end of expiration and expressed in mmHg. Most research results indicate keeping the transducer zeroed at the level of the mid-axillary line at the iliac crest level, and instill 25mL of sterile saline. Strong evidence must be developed.

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The Abdominal Compartment Syndrome

Malbrain

Cheatham

Sugrue

et al. 2010

Surgical Intensive Care Medicine

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The abdominal compartment syndrome (ACS) was first described in surgical patients with abdominal aortic aneurysm repair, trauma, bleeding, or infection, but in recent years it has also been described in patients with other pathologies such as burn injury and sepsis and in medical patients. This F1000 Medicine Report is intended to provide critical care physicians a clear insight into the current state of knowledge regarding intra-abdominal hypertension (IAH) and ACS, and will focus primarily on the recent literature as well as on the definitions and recommendations published by the World Society of the Abdominal Compartment Syndrome. The definitions regarding increased intraabdominal pressure (IAP) will be listed, followed by a brief but comprehensive overview of the different mechanisms of organ dysfunction associated with IAH. The gold standard measurement technique for IAP as well as recommendations for organ function support in patients with IAH and options for medical and surgical treatment of IAH and ACS will be discussed.

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Untitled

Cited by 100 publications

References 11 publications

Current recognition and management of intra-abdominal hypertension and abdominal compartment syndrome among tertiary Chinese intensive care physicians

Current recognition and management of intra-abdominal hypertension and abdominal compartment syndrome among tertiary Chinese intensive care physicians

Intra-abdominal pressure: an integrative review

The Abdominal Compartment Syndrome

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