Abdominal Compartment Syndrome: Current Problems and New Strategies

Parsak, Cem Kaan; Seydaoğlu, Gülşah; Sakman, Gürhan; Acartürk, Tahsin Oğuz; Karakoç, Emre; Hanta, İsmail; Alparslan, Ali H.; Satar, Salim

doi:10.1007/s00268-007-9286-x

Cited by 39 publications

(37 citation statements)

References 31 publications

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“…Die Therapie des abdominellen Kompartments bei chirurgischen Patienten besteht in der Dekompressionslaparotomie und Vorübergehender Anlage eines Laparostomas [29]. Ein intraabdomineller Druck von 25 mmHg und mehr ist mit einer erhöhten Mortalität verbunden und eine absolute Indikation zur chirurgischen Dekompression [20]. Abhän-gig von der Infektsituation kann der sekundäre Verschluss des Abdomens mithilfe eines Netzes erfolgen [29].…”

Section: Bauchdeckenverschluss Management Des Abdominellen Kompartmentsunclassified

Chirurgische Therapie der Peritonitis

Strobel,

Werner,

Büchler

2011

Chirurg

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Despite significant progress the therapy of peritonitis remains challenging. With a mortality of up to 20% peritonitis is a predominant cause of death due to surgical infections. An early and efficient source control combined with effective antibiotic therapy and modern intensive care and sepsis therapy are definitive for the outcome and prognosis of secondary peritonitis. In approximately 90% of patients an effective source control can be achieved by one single operation with extensive peritoneal lavage. A reoperation is necessary in only about 10% of patients. The aggressive concepts of planned relaparotomy or open packing are associated with increased morbidity and are indicated only in rare cases. The gold standard is to attempt a definitive source control by one single operation. An operative revision should be performed only on demand. The antibiotic therapy should begin with a broadly calculated empirical therapy and should later be adapted to microbiological findings. The therapy of sepsis requires standardized and state of the art intensive care.

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Section: Bauchdeckenverschluss Management Des Abdominellen Kompartmentsunclassified

Chirurgische Therapie der Peritonitis

Strobel,

Werner,

Büchler

2011

Chirurg

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“…These effects can lead to the translocation of bacteria from the gut and intestinal oedema, predisposing the animal to multi-organ dysfunction syndrome, which affects vital body systems [4,9,10]. If IAH exceeds the limits of adaptation, serious clinical lung complications can develop [2][3][4][5]26]. The available findings suggest that abdominal pressures above 18 mmHg could irreversibly damage pulmonary cells, and both coagulation necrosis parameters and the number of cells undergoing apoptosis would increase with increased pressure.…”

Section: Effect Of Iah On Lung Tissuementioning

confidence: 99%

“…An IAP exceeding 12 mmHg is considered to be pathologically elevated and has been termed intra-abdominal hypertension (IAH). An IAP exceeding 20 mmHg with evidence of organ dysfunction/failure is defined as abdominal compartment syndrome (ACS) [2][3][4][5]. The most common causes of IAH are intra-and retro-peritoneal haemorrhage, visceral oedema related to post-resuscitation states, pancreatitis, laparoscopy with pneumoperitoneum, bowel distension and intra-abdominal infection [5].…”

Section: Introductionmentioning

confidence: 99%

Lung tissue apoptosis in abdominal hypertension

Akbulut

Yazıcıoğlu

Şahin

et al. 2011

Eur J Trauma Emerg Surg

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“…Patients that were on mechanical ventilation had a higher mortality rate. Examining the issue of IAP, other researchers have reported similar changes 15,16,17 , i.e. the increase in IAP caused an increase in respiratory rate, heart rate, CVP, PaCO 2 , urea, serum creatinine and APACHE II score, while PaO 2 , SpO 2 , systolic and diastolic blood pressure, the amount of excreted urine, creatinine clearance, and mental status declined.…”

Section: Discussionmentioning

confidence: 82%

Influence of Intra-Abdominal Pressure on the Basic Vital Functions and Final Treatment Outcome

Svorcan

Stojanović

Stevanović

et al. 2016

ACC

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SUMMARY -Th e purpose of the study was to point to the importance of measuring intra-abdominal pressure (IAP) and of early recognition of the consequences of increased IAP on basic vital functions. Measurement of IAP via urinary bladder was conducted every 12 hours in 70 surgical patients with acute abdominal syndromes not previously operated on. Based on the measured IAP values, all patients were divided into groups of patients with normal IAP values (n=20) and patients with increased IAP values (n=50) . Vital functions and basic laboratory analysis were monitored and the values obtained were compared with IAP in both patient groups. A statistically signifi cant diff erence was found in body weight, body mass index, urine output, creatinine, urea, heart rate, partial pressure of oxygen (PaO 2 ) and partial pressure of carbon dioxide (PaCO 2 ) between patients with normal and increased IAP values. Th e increase in IAP values was found to be associated with an increase in PaCO 2 , respiratory rate, peak inspiratory pressure, central venous pressure, heart rate, Acute Physiology, Age and Chronic Health Evaluation II score, mortality rate, creatinine and urea values, and number of days of treatment in the intensive care unit. At the same time, the values of PaO 2, blood oxygen saturation, diuresis and abdominal perfusion pressure were declining. IAP measurement is an old, cost-eff ective, reliable technique that is easy to perform and should be applied in all high risk patients.

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Abdominal Compartment Syndrome: Current Problems and New Strategies

Abstract: In patients with ACS emergency, it is recommended that decompressive laparotomy to be performed even if the IAP falls below 25 mmHg. For patients with IAP levels higher than 25 mmHg, the IAP should be meticulously brought below the cutoff level during the postoperative period.

Cited by 39 publications

References 31 publications

Chirurgische Therapie der Peritonitis

Chirurgische Therapie der Peritonitis

Lung tissue apoptosis in abdominal hypertension

Influence of Intra-Abdominal Pressure on the Basic Vital Functions and Final Treatment Outcome

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