Endoscopic components separation for abdominal compartment syndrome

Voss, Matthew; Pinheiro, J.; Reynolds, James D.; Greene, Richard M.; Dewhirst, Mark W.; Vaslef, Steven N.; Clary, Erik M.; Eubanks, William S.

doi:10.1016/s0002-9610(03)00171-5

Cited by 20 publications

(11 citation statements)

References 23 publications

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“…Recently, a less invasive percutaneous endoscopic abdominal wall component separation (EACS) technique has been described [116]. With this technique, the abdominal capacity (maximal stretched volume) increased by 1 L while IAP decreased from 15.9 ± 2.1 to 11 ± 1.5 mm Hg (P < 0.001) [116].…”

Section: Sixth Step: Consider Less Invasive Surgerymentioning

confidence: 99%

“…With this technique, the abdominal capacity (maximal stretched volume) increased by 1 L while IAP decreased from 15.9 ± 2.1 to 11 ± 1.5 mm Hg (P < 0.001) [116]. Another alternative to midline laparotomy is subcutaneous linea alba fasciotomy (SLAF) which seems a promising approach especially in secondary IAH and ACS [117].…”

Section: Sixth Step: Consider Less Invasive Surgerymentioning

confidence: 99%

See 1 more Smart Citation

The role of abdominal compliance, the neglected parameter in critically ill patients — a consensus review of 16. Part 2: measurement techniques and management recommendations

Malbrain¹,

Laet²,

Waele³

et al. 2014

Anaesthesiol Intensive Ther

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The recent definitions on intra-abdominal pressure (IAP), intra-abdominal volume (IAV) and abdominal compliance (C ab ) are a step forward in understanding these important concepts. They help our understanding of the pathophysiology, aetiology, prognosis, and treatment of patients with low C ab . However, there is still a relatively poor understanding of the different methods used to measure IAP, IAV and C ab and how certain conditions may affect the results. This review will give a concise overview of the different methods to

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Section: Sixth Step: Consider Less Invasive Surgerymentioning

confidence: 99%

Section: Sixth Step: Consider Less Invasive Surgerymentioning

confidence: 99%

The role of abdominal compliance, the neglected parameter in critically ill patients — a consensus review of 16. Part 2: measurement techniques and management recommendations

Malbrain¹,

Laet²,

Waele³

et al. 2014

Anaesthesiol Intensive Ther

View full text Add to dashboard Cite

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“…The determination of tissue oxygenation and blood fl ow with the oxylab pO 2 is well supported in the literature [12,13] .…”

Section: Tissue Oxygenation and Blood Flowmentioning

confidence: 70%

The Immediate Effect of Castration on Female Rabbit Bladder Blood Flow and Tissue Oxygenation

Badger

Whitbeck²,

Kogan³

et al. 2006

Urol Int

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Background: The female urinary bladder is a target organ for estrogen. Reductions in circulating estrogen have been associated with urothelial and vaginal atrophy and bladder disorders including incontinence and increased incidence of bladder infections. We determined the effect of short-term ovariectomy on sex hormones, bladder blood flow, and tissue oxygenation in the rabbit model. Materials and Methods: Female New Zealand White rabbits were ovariectomized and evaluated on 1, 3, and 7 days after ovariectomy. Tissue oxygenation (pO₂) and blood flow were measured with oxylab system of real time measurements. Serum estrogen and progesterone were determined at sacrifice. Tissue hypoxia was localized histologically using Hypoxyprobe-1 immunohistochemistry. Results: Short-term ovariectomy caused rapid decreases in serum estrogen and progesterone, significant decreases in urothelial oxygenation and blood flow. No significant decreases in blood flow or oxygenation were noted for the detrusor smooth muscle. Immunohistochemistry confirmed the presence of urothelial hypoxia at all times after ovariectomy. Bladder muscle did not demonstrate significant levels of hypoxia. Conclusion: The bladder urothelium is extremely sensitive to short-term ovariectomy, with significant urothelial hypoxia seen by post-ovariectomy day 1. Urothelial hypoxia may play a significant role in pelvic pain syndromes, incontinence, and increased susceptibility to bladder infection.

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“…Together with endoscopic abdominal wall components separation (EACS) [61] this may be an attractive alternative in patients who do not require an abdominal surgical intervention. In patients with massive burns and secondary ACS, one useful method is ultrasound-guided paracentesis than can decrease IAP and prevent progression to ACS.…”

Section: Managing Iah In the Trauma Patientsmentioning

confidence: 99%

Intra-abdominal hypertension and abdominal compartment syndrome in pancreatitis, paediatrics, and trauma

Waele

Ejike

Leppäniemi³

et al. 2015

Anaesthesiol Intensive Ther

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Intra-abdominal hypertension (IAH) is an important contributor to early organ dysfunction among patients with trauma and sepsis. However, the impact of increased intra-abdominal pressure (IAP) among pediatric, pregnant, non-septic medical patients, and those with severe acute pancreatitis (SAP), obesity, and burns has been studied less extensively. The aim of this review is to outline the pathophysiologic implications and treatment options for IAH and abdominal compartment syndrome (ACS) for the above patient populations. We searched MEDLINE and PubMed to identify relevant studies. There is an increasing awareness of IAH in general medicine. The incidence of IAH and, to a lesser extent, ACS is high among patients with SAP. IAH should always be suspected and IAP measured routinely. In children, normal IAP in mechanically ventilated patients is approximately 7 ± 3 mm Hg. As an IAP of 10−15 mm Hg has been associated with organ damage in children, an IAP greater than 10 mm Hg should be considered IAH in these patients. Moreover, as ACS may occur in children at an IAP lower than 20 mm Hg, any elevation in IAP higher than 10 mm Hg associated with new organ dysfunction should be considered ACS in children until proven otherwise. Monitor IAP trends and be aware that specific interventions may need to be instituted at lower IAP than the current ACS definitions accommodate. Finally, IAH and ACS can occur both in abdominal trauma and extra-abdominal trauma patients. Early mechanical hemorrhage control and the avoidance of excessive fluid resuscitation are key elements in preventing IAH in trauma patients. IAH and ACS have been associated with many conditions beyond the general ICU patient. In adults and in children, the focus should be on the early recognition of IAH and the prevention of ACS.Patients at risk for IAH should be identified early during their treatment (with a low threshold to initiate IAP monitoring). Appropriate actions should be taken when IAP increases above 20 mm Hg, especially in patients developing difficulty with ventilation. Although on-operative measures should be instituted first, one should not hesitate to resort to surgical decompression if they fail.

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Endoscopic components separation for abdominal compartment syndrome

Cited by 20 publications

References 23 publications

The role of abdominal compliance, the neglected parameter in critically ill patients — a consensus review of 16. Part 2: measurement techniques and management recommendations

The role of abdominal compliance, the neglected parameter in critically ill patients — a consensus review of 16. Part 2: measurement techniques and management recommendations

The Immediate Effect of Castration on Female Rabbit Bladder Blood Flow and Tissue Oxygenation

Intra-abdominal hypertension and abdominal compartment syndrome in pancreatitis, paediatrics, and trauma

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