Current insights in intra-abdominal hypertension and abdominal compartment syndrome: open the abdomen and keep it open!

laet, Inneke E. De; Ravyts, M; Vidts, Wesley; Valk, Jody; Waele, Jan J. De; Malbrain, Manu L N G

doi:10.1007/s00423-008-0347-x

Cited by 71 publications

(63 citation statements)

References 116 publications

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“…Although WSACS has described a graded approach to the management of IAH/ACS, which can be used to avoid the need for surgical decompression in many patients, surgical abdominal decompression has long been the standard treatment for the patient who develops ACS Cheatham et al, 2007;de Laet et al, 2008a). However, many things should also be taken into consideration with decompressive laparotomy, because the decompression could bring about massive intra-abdominal bleeding, persisting open abdomen, and subsequent extensive abdominal wall reconstruction.…”

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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“…Grades III and IV IAH are referred to as abdominal compartment syndrome [5]. Although trauma remains the major cause of IAH in infants and children, IAH has been noted in many nontraumatic conditions, including bowel obstruction and perforation [4,5]. Abdominothoracic transmission of IAP is between 20% and 80%; a good approximation of transmitted intrathoracic pressure is 50% (IAP/2) [5].…”

Section: To the Editormentioning

confidence: 99%

“…Intra-abdominal hypertension (IAH) is defined as sustained or repeated pathologic elevation of IAP more than 12 mmHg, and subclassified as grade I to IV depending on severity (I = 12-15 mmHg, II = 16-20 mmHg, III = 20-25 mmHg, IV N 25 mmHg). Grades III and IV IAH are referred to as abdominal compartment syndrome [5]. Although trauma remains the major cause of IAH in infants and children, IAH has been noted in many nontraumatic conditions, including bowel obstruction and perforation [4,5].…”

Section: To the Editormentioning

confidence: 99%

Urgent laparotomy helped resuscitate a neonate with increased intra-abdominal pressure who had cardiac arrest with anesthetic induction

Mishra

Sadhasivam

Mahmoud

2012

Journal of Clinical Anesthesia

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“…22,35,44 If these nonoperative measures are not successful, the specific surgical treatment for ACS is abdominal decompression by laparotomy with postoperative open-abdomen management. 7,20,27,44,46 The vacuum pack technique, also known as negativepressure dressing for temporary abdominal closure, has been associated with good outcomes in adults and children. 25,47 In a retrospective study in neonates, 47 use of the vacuum pack technique resulted in 85.7% successful primary fascial closure in a median of 4 days.…”

Section: B Amentioning

confidence: 99%

Abdominal Compartment Syndrome in Children

Newcombe

Mathur

Ejike

2012

Critical Care Nurse

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Abdominal compartment syndrome is defined as sustained intra-abdominal pressure greater than 20 mm Hg (with or without abdominal perfusion pressure <60 mm Hg) associated with new organ failure or dysfunction. The syndrome is associated with 90% to 100% mortality if not recognized and treated in a timely manner. Nurses are responsible for accurately measuring intra-abdominal pressure in children with abdominal compartment syndrome and for alerting physicians about important changes. This article provides relevant definitions, outlines risk factors for abdominal compartment syndrome developing in children, and discusses an instructive case involving an adolescent with abdominal compartment syndrome. Techniques for measuring intra-abdominal pressure, normal ranges, and the importance of monitoring in the critical care setting for timely identification of intra-abdominal hypertension and abdominal compartment syndrome also are discussed.

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Current insights in intra-abdominal hypertension and abdominal compartment syndrome: open the abdomen and keep it open!

Cited by 71 publications

References 116 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

Urgent laparotomy helped resuscitate a neonate with increased intra-abdominal pressure who had cardiac arrest with anesthetic induction

Abdominal Compartment Syndrome in Children

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