Effects of Abdominal Decompression on Cardiopulmonary Function and Visceral Perfusion in Patients with Intra-abdominal Hypertension

Abstract

Abdominal decompression in patients with increased IAP improves preload, pulmonary function, and visceral perfusion. Elevated IAP has important effects on PAOP, which makes the PAOP an unreliable index of preload in these patients.

Myelofibrosis‐associated massive splenomegaly: A cause of increased intra‐abdominal pressure, pulmonary hypertension, and positional dyspnea

“…In a similar pattern, pulmonary hemodynamics were affected in otherwise healthy lungs when IAP was high [21]. This effect was reversible, and normal pulmonary function was restored in patients with increased IAP when abdominal decompression was performed [22]. Positional changes of IAP were significant in our patient, and low IAP in the left lateral decubitus position could explain the relief of symptoms.…”

Recovery from respiratory failure after decompression laparotomy for severe acute pancreatitis

“…It was reported that ACS generally affects cardiac, pulmonary and renal function, and contributes to multi-organ dysfunction with a mortality rate ranging 10%-50% within two weeks [6,[8][9][10][11] . The degree of IAP in patients with SAP seems to correlate with the degree of organ dysfunction, the severity of disease, the length of intensive care unit stay and mortality [6,[8][9][10][11] . Pulmonary side effects mediated by IAH, such as atelectasis, edema, decreased oxygen transport and increased intrapulmonary shunt fraction, are caused by compression of pulmonary parenchyma.…”

“…Furthermore, a study in ACS trauma patients demonstrated an increased rate of pulmonary infections [13] . A n i m a l a n d h u m a n s t u d i e s s h o w e d t h a t abdominal decompression laparotomy can reverse the cardiopulmonary and abdominal effects of ACS [9,10] . In our patients, decompression laparotomy led to decreased IAP levels, improved Horowitz indices and increased lung compliance (Figure 3).…”

Intraabdominal hypertension and abdominal compartment syndrome in the intensive care unit

“…Critical IAP for surgical decompression is not yet defined, but practitioners should note all pathophysiologic effects related to ACS and act accordingly. Reversal of organ deterioration in addition to normalization of preload, pulmonary function, splanchnic circulation and diuresis in ACS is observed after abdominal decompression (7,16,25).…”