A critical care nurse's guide to intra abdominal hypertension and abdominal compartment syndrome

Spencer, Penny; Kinsman, Leigh; Fuzzard, Kim

doi:10.1016/j.aucc.2007.10.005

Cited by 15 publications

(27 citation statements)

References 31 publications

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“…It is essential for nurses to regularly monitor IAP and organ perfusion to predict adverse consequences and be proactive in the management of patients at risk. [7] IAP measurement is effective, and efficient way for determining the existence of IAH. It can direct the management.…”

Section: Introductionmentioning

confidence: 99%

The effect of reference position versus right lateral position on the intra-abdominal pressure in mechanically ventilated patients

Mahran¹,

Abd‐Elshafy²,

Neem³

et al. 2018

JNEP

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Background and objective: Intra-abdominal hypertension (IAH) is a frequent plentiful problem in patients admitted to critical care units. It ranges from a surge incidence of morbidity and mortality to a particular need for nursing health care, so recognition of the occurrence of IAH is a very critical issue for critical care nurses and physician. This study aimed to recognize the effects of various body position with the various head of bed elevation on the intra-abdominal pressure (IAP) in patients with mechanical ventilation. Methods: Design: A non-randomized, prospective observational study was used. Setting: Trauma and general intensive care units at Assuit University Hospitals. Method: In a prospective observational study, during the third day of mechanical ventilation, 60 patients were screened for IAP via a urinary catheter, in two various body positions in three separate degrees of the head of the bed (HOB) elevation (0 • , 15• , and 30 • ). The position was changed at least 4 hours apart over a 24-h period.Results: In lateral recumbence, IAP measurements were significantly elevated compared to supine position, they were 19.70 ± 3.09 mmHg versus 16.00 ± 3.14 (p < .001), 22.80 ± 3.56 mmHg versus 19.03 ± 2.95 (p < .001), and 26.08 ± 3.59 mmHg versus 21.46 ± 2.90 versus (p < .001) at 0 • , 15• , and 30• respectively. The mean of IAP difference was 3.7 ± 3.0 mmHg at 0 • , 3.8 ± 1.00 mmHg at 15• , and 5.5 ± 1.01 mmHg at 30 • (p < .005).Conclusions: IAP reading is significantly elevated by changing from supine to lateral position especially with HOB elevation and significantly correlated with mortality rate in patients with mechanical ventilation

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Section: Introductionmentioning

confidence: 99%

The effect of reference position versus right lateral position on the intra-abdominal pressure in mechanically ventilated patients

Mahran¹,

Abd‐Elshafy²,

Neem³

et al. 2018

JNEP

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show abstract

“…Primary ACS results from a direct injury within the abdomen and pelvic region (e.g., a blunt or penetrating trauma, ruptured abdominal aortic aneurysm or laparotomy). [1234] A direct injury to the abdomen creates an opportunity for hemorrhage and tissue injury. [12] The initial bleeding causes hypoperfusion to the tissues and the accumulating of blood clots within the abdomen initiates intra-abdominal hypertension (IAH).…”

Section: Introductionmentioning

confidence: 99%

“…[1234] A direct injury to the abdomen creates an opportunity for hemorrhage and tissue injury. [12] The initial bleeding causes hypoperfusion to the tissues and the accumulating of blood clots within the abdomen initiates intra-abdominal hypertension (IAH). [2] ACS is most commonly diagnosed in patients with sustaining abdominal or pelvic traumas or in those suffering from some other intra-abdominal hemorrhagic catastrophes.…”

Section: Introductionmentioning

confidence: 99%

“…[5678] The incidence of ACS is reported to be up to 35% in the intensive care population, with reduced survival when compared with other intensive care patients. [1] Mortality and morbidity rates are extremely high when patients develop ACS, and recognition and treatment are time critical. [9] Although the cause of IAH can vary, and the degree of organ dysfunction can differ from patient to patient, the reason for this is the effect of decreasing blood flow and increasing pressure on abdominal organs and surrounding organs that creates the end organ dysfunction that defines ACS.…”

Section: Introductionmentioning

confidence: 99%

“…This is not a reflection of the patient's fluid status but rather an indicator of the rising intra-thoracic pressure and systemic vascular resistance. [27111213] The increase of thoracic pressures is also manifested by increasing peak airway and plateau pressures that can be measured in a mechanically ventilated patient. These pressures are seen to rise early in the process of ACS (IAP 15 mmHg), and continue to rise as the IAP increases.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the relationship between pelvic fracture and abdominal compartment syndrome in traumatic patients

Ali

Heidari

Shahbazi

2013

J Emerg Trauma Shock

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Introduction:An increase in abdominal pressure can lead to so-called intra–abdominal compartment syndrome (ACS). Multiple factors such as an increase in retroperitoneal volume due to pancreatitis, bleeding and edema as a result of pelvic fracture can lead to compartment syndrome. Prevention is better than cure in compartment syndrome. By measuring the intra-abdominal pressure (IAP) through the bladder, a quick and accurate assessment of abdominal pressure is achieved. Therefore, this study aimed to evaluate the relationship between pelvic fracture and ACS in traumatic patients.Materials and Methods:This research was a descriptive–analytical study conducted on 100 patients referring to the Shiraz Nemazee Hospital in 2010. IAP was monitored every 4 h in patients suspected to be at high risk for ACS, e.g., those undergoing severe abdominal trauma and pelvic fracture. The IAP was measured via the urinary bladder using the procedure described by Kron et al. Data collected were analyzed using SPSS software.Results:The findings showed that ACS occurred in 28 of 100 patients. With regard to the associated injuries with abdominal trauma, 19% of all patients and 46/42% of the patients with ACS had pelvic fracture. Chi-square test revealed a significant relationship between pelvic fracture and incidence rate of ACS (P < 0.001).Conclusions:According to the collected data, pelvic fracture due to a trauma can be one of the important causes of an increase in IAP and ACS. In this lethal condition, prevention is better than cure. Therefore, serial measurement of IAP through the bladder in high-risk patients (those with pelvic fracture by trauma) is recommended to the nurses to diagnose this condition and to decrease the incidence of mortality.

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A survey of critical care nurses’ knowledge of intra-abdominal hypertension and abdominal compartment syndrome

Hunt

Frost

Newton

et al. 2017

Australian Critical Care

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A critical care nurse's guide to intra abdominal hypertension and abdominal compartment syndrome

Cited by 15 publications

References 31 publications

The effect of reference position versus right lateral position on the intra-abdominal pressure in mechanically ventilated patients

The effect of reference position versus right lateral position on the intra-abdominal pressure in mechanically ventilated patients

Evaluation of the relationship between pelvic fracture and abdominal compartment syndrome in traumatic patients

A survey of critical care nurses’ knowledge of intra-abdominal hypertension and abdominal compartment syndrome

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