Abdominal Compartment Syndrome in Polytrauma

Pleva, Leopold; Šír, Milan; Mayzlík, J

doi:10.5507/bp.2004.014

Cited by 6 publications

(5 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Aggressive intraoperative fluid therapy may cause an increase in IAP up to 15 to 25 mmHg. [13] The same result can be seen with ECC and this is the cause of multiorgan failure, particularly in conjunction with the use of inotropic drugs. [17] In our study, we observed no significant difference between the groups according to the positive fluid balance.…”

Section: Intra-abdominal Hypertension May Cause Visceral Organ Hypoperfusion Intestinal Ischemia As Wellmentioning

confidence: 67%

“…Intensive fluid therapy, particularly with crystalloid solutions, is likely to cause an increase in IAP. [13,14] Andrási et al [15] demonstrated a significant impact of CPB on the mesenteric circulation in an animal model where CPB causes a splanchnic hypoperfusion. Hypothermia and rewarming are associated with a release of vasoactive substances, causing vasoconstriction at the microcirculatory level and the gut mucosa, which may lead to bowel edema.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Factors associated with increased intra-abdominal pressure in patients undergoing cardiac surgery

Kılıç

Yapıcı

et al. 2020

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

Bu çalışmada kalp cerrahisi yapılan hastalarda intraabdominal basınç değişiklikleri ve artmış intraabdominal basınç ile ilişkili risk faktörleri araştırıldı. Ça lış ma pla nı: Temmuz 2016 -Ocak 2017 tarihleri arasında kardiyopulmoner baypas ile kalp cerrahisi yapılan toplam 100 hasta (74 erkek, 26 kadın; ort. yaş 55.9±14.3 yıl; dağılım, 19-75 yıl) çalışmaya alındı. Hastaların demografik ve klinik özellikleri ve ameliyat sırası ve ameliyat sonrası verileri kaydedildi. İntraabdominal basınç, anestezi indüksiyonu sonrası, yoğun bakım ünitesine girişte ve ameliyat sonrası 12. ve 24. saatlerde üriner kateter ile ölçüldü. Hastalar intrabdominal basınca göre Grup 1 (≥12 mmHg; n=49) ve Grup 2 (<12 mmHg; n=51) olmak üzere iki gruba ayrıldı. Bul gu lar: Tek değişkenli regresyon analizinde yüksek intraabdominal basınç anestezi indüksiyonundan sonra ölçülen intraabdominal basınç (olasılık oranı= 0.70, p= 0.001), yaş (olasılık oranı= 0.95, p= 0.004), hipertansiyon (olasılık oranı=4.51, p= 0.0001), kardiyopulmoner baypas süresi (olasılık oranı= 0.97, p= 0.0001), ameliyat sırası laktat düzeyleri (olasılık oranı= 0.53, p= 0.0001), eritrosit kullanımı (olasılık oranı=0.24, p=0.0001), dopamin kullanımı (olasılık oranı=0.21, p=0.002), dobutamin (olasılık oranı= 0.28, p= 0.005), noradrenalin kullanımı (olasılık oranı= 0.25, p= 0.016), ameliyat sonrası laktat düzeyleri (olasılık oranı= 0.60, p= 0.0001), kros-klemp süresi (olasılık oranı= 0.97, p= 0.000), atriyal fibrilasyon (olasılık oranı=5.89, p= 0.004) ve akut böbrek hasarı (olasılık oranı=8.33, p= 0.048) ile ilişkili bulundu. Çok değişkenli analizde ise, başlangıç intraabdominal basınç (olasılık oranı= 0.70, p= 0.045), yaş (olasılık oranı= 0.93, p= 0.032), hipertansiyon (olasılık oranı=6.87, p= 0.023), kardiyopulmoner baypas süresi (olasılık oranı= 0.98, p= 0.062), ameliyat sırası laktat düzeyleri (olasılık oranı= 0.57, p= 0.035) ve eritrosit kullanımı (olasılık oranı= 0.19, p= 0.003) istatistiksel olarak anlamlı olmayı sürdürdü. So nuç: Çalışma sonuçlarımız kalp cerrahisi yapılan hastalarda yaş, hipertansiyon, kardiyopulmoner baypas süresi, ameliyat sırası laktat düzeyleri ve eritrosit kullanımının intraabdominal basınç yüksekliği ile ilişkili risk faktörleri olduğunu göstermektedir. Bu risk faktörlerinin bilinirliğinin artması ve intraabdominal basınç ölçümünün ameliyat sonrası değişken hemodinami, düşük kalp debisi ve yüksek laktat düzeyleri olan hastaların standart takip şemasına eklenmesi, komplikasyonların erken tanısı ve morbiditenin azaltılmasında yararlı olabilir.

show abstract

Section: Intra-abdominal Hypertension May Cause Visceral Organ Hypoperfusion Intestinal Ischemia As Wellmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Factors associated with increased intra-abdominal pressure in patients undergoing cardiac surgery

Kılıç

Yapıcı

et al. 2020

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

show abstract

“…The lower mortality found in our study suggests that IAH and ACS can be managed using non-operative methods, which will prevent morbidity associated with exploratory laparotomy. However L. Pleva et al suggested that in the event of any suspicion for acute elevation of IAP and development of ACS the performance of decompression laparotomy is indicated even with the assumption of negative preoperative finding [ 24 ]. Nevertheless identification of this group of patients by continuous bladder pressure monitoring who develop ACS due to increased fluid inside the abdominal cavity and not due to ongoing hemorrhage is essential as the morbidity of a negative exploration can be avoided by simple decompressive NOI and can buy some more time for successful completion of NOM.…”

Section: Discussionmentioning

confidence: 99%

Study of the occurrence of intra-abdominal hypertension and abdominal compartment syndrome in patients of blunt abdominal trauma and its correlation with the clinical outcome in the above patients

Tiwari

Pandya

2016

World J Emerg Surg

View full text Add to dashboard Cite

BackgroundIntra-abdominal pressure (IAP) measurements have been identified as essential for diagnosis and management of both intra-abdominal hypertension (IAH) and Abdominal compartment syndrome (ACS). It has gained prominent status in ICUs worldwide. We aimed to evaluate the utility of measurement of rise in bladder pressure to assess IAP levels in blunt abdominal trauma (BAT) patients.Patients and methodsThirty patients of BAT with solid organ injuries were included in this study. Intra-abdominal pressure was measured through a Foleys bladder catheter throughout their stay. Bladder pressure was compared with clinical parameters like mean arterial pressures(MAP), respiratory rate(RR), serum creatinine(SC) and abdominal girth(AG) and also with outcome in terms of intervention whether operative(OI) or non-operative(NOI).ResultsBladder pressure showed significant correlation with MAP (R = −0.418; P = 0.022), AG (R = 0.755; P = 0.000), SC (R = 0.689; P = 0.000) and RR (R = 0.537; P = 0.002). Bladder pressure (R = 0.851; P = 0.000), SC (R = 0.625; P = 0.000), MAP (R = −0.350; P = 0.058) and maximum AG difference (R = 0.634; P = 0.000) showed significant correlation with intervention. In total, 17 patients (56 %) required intervention, 9 patients (30 %) underwent NOI (pigtailing or aspiration) while 8 (27 %) needed OI. More than 3 derailed parameters were associated with 100 % intervention (Mean 3.47, SD-1.23). High APACHE III score on admission (>40) was associated with increased intervention (p = 0.001). Intervention correlates well with Grade of injury (p = 0.000) and not with number of organs injured (p = 0.061). Blood transfusion of 2 or more units of blood was associated with increased intervention (p = 0.000).ConclusionIncreased bladder pressure and other clinical parameters (MAP, SC, RR and change in AG) correlates well with intervention. Elevated bladder pressure correlates well with other clinical parameters in patients with BAT. Bladder pressure, SC, MAP, RR and AG difference can be used to determine the group of patients that can be managed conservatively and those that would benefit with minimal intervention or exploration. During Non-operative management (NOM) of patients with BAT and multiple solid organ injuries, IAP monitoring may be a simple and objective guideline to suggest further intervention whether NOI or OI. Although routine bladder pressure measurements will result in unnecessary monitoring of large number of patients it is hoped that patients with IAH can be detected early and subsequent ACS with morbid abdominal exploration can be prevented. However the criterion for non-operative failure and the point of decompression needs further refinement to prevent an increase of nontherapeutic operations.

show abstract

“…Another contributing factor is massive blood loss necessitating aggressive resuscitation with Iv fluids and blood transfusion, and intraperitoneal and retroperitoneal bleeding [34]. Even in these critically ill patients, decompressive laparotomy reduces IAP and may also discover major bleeding which can be treated surgically [35] .…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of intra-abdominal hypertension and compartment syndrome in surgical patients in critical care units at Kenyatta National Hospital

et al. 2016

View full text Add to dashboard Cite

BackgroundIntra-abdominal hypertension (IAH) affects almost every organ sytem.If it is not detected early and corrected, mortality would be high. The prevalence of IAH and abdominal compartment syndrome (ACS) at Kenyatta National Hospital (KNH) critical care units is not known. The aim of this sudy was to determine the prevalence and factors associated with development of IAH/ACS among critically ill surgical patients.MethodsThis was a cross sectional descriptive study involving surgical patients in critical care units at KNH, carried out from March 2015 to October 2015.One hundred and thirteen critically ill and ventilated patients 13 years or older were recruited into the study.Krohn’s intravesical method was used to measure intra- abdominal pressure (IAP). Measurements were done at first contact, then at 12 and 24 h. Additional parameters recorded included: laboratory tests such as serum bilirubin and total blood count as well as clinical parameters such as urine output, vital signs and peak airway pressure, among others.Frequency, means and standard deviation were used to describe the data. Categorical variables e.g. age, were analysed using Chi square test and continous variables using student ‘t’ test and Mann Whitney test as appropriateResultA total of 113 consecutive surgical patients admitted to the critical care units were recruited. Of our study population, 71.7% (by IAP max) and 67.3% (by IAP mean) had IAH. Abdominal compartment syndrome (ACS) developed in 4.4% of the population. The following factors were significant determinants of risk of IAH : amount of IV fluids over 24 h (3949.6 vs 2931.1, p = 0.003, adjusted OR 1.0 [1.0-1.002]), haemoglobin values at admission (9.9 vs 12.0, p = <0.012, adjusted OR 0.6 [0.4-0.9]), peak airway pressure (28.4 vs 17.3; p = 0.018, adjusted OR 1.6 [1.1-2.4]) and synchronised intermittent mandatory ventilation (SIMV) (60 vs 32; p = 0.041, adjusted OR 1.4 [0.78-2.04]).Of those who had IAH; age, amount of iv fluids over 24 h, fluid balance and ventilator mode were significant determinants of risk of progression to ACS .ConclusionThe prevalence of intraabdominal hypertension and abdominal compartment syndrome at KNH is high. Clinical parameters pertaining to fluids administration and ventilator mode are siginificant determinants.Electronic supplementary materialThe online version of this article (doi:10.1186/s12873-017-0120-y) contains supplementary material, which is available to authorized users.

show abstract

Abdominal Compartment Syndrome in Polytrauma

Cited by 6 publications

References 18 publications

Factors associated with increased intra-abdominal pressure in patients undergoing cardiac surgery

Factors associated with increased intra-abdominal pressure in patients undergoing cardiac surgery

Study of the occurrence of intra-abdominal hypertension and abdominal compartment syndrome in patients of blunt abdominal trauma and its correlation with the clinical outcome in the above patients

Prevalence and predictors of intra-abdominal hypertension and compartment syndrome in surgical patients in critical care units at Kenyatta National Hospital

Contact Info

Product

Resources

About