Intra-abdominal hypertension and the abdominal compartment syndrome

Moore, A F K; Hargest, R; Martin, M; Delicata, R J

doi:10.1002/bjs.4703

Cited by 115 publications

(101 citation statements)

References 68 publications

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“…Thus, cirrhosis induces the development of hyperkinetic circulation, likely to be characterized by tachycardia and increased myocardial ejection fraction [8]. Additionally, ascites, which commonly coexists with cirrhosis, increases intra-abdominal pressure, leading to hemodynamic abnormalities of the myocardium and impairing renal function; moreover, it affects intra-thoracic pressure and can alter the anatomical position of the heart, and therefore its electrical axis [9,10].…”

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confidence: 99%

QT Interval Prolongation and QRS Voltage Reduction in Patients with Liver Cirrhosis

Cichoż‐Lach¹,

Tomaszewski²,

Kowalik³

et al. 2015

Adv Clin Exp Med

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Background. Liver cirrhosis is associated with functional abnormalities of the cardiovascular system with coexisting electrocardiographic (ECG) abnormalities. Objectives.The aim was to analyze ECG changes in patients with cirrhosis, to evaluate whether alcoholic etiology of cirrhosis and ascites has an impact on ECG changes. Material and Methods. The study involved 81 patients with previously untreated alcoholic cirrhosis (64 patients with ascites, classes B and C according to the Child-Pugh classification; and 17 without ascites, categorized as class A); 41 patients with previously untreated cirrhosis due to chronic hepatitis C (HCV -30 patients with ascites, classes B and C; and 11 without ascites, class A); 42 with alcoholic steatohepatitis and 46 with alcoholic steatosis. The control group consisted of 32 healthy volunteers. Twelve-lead ECG recordings were performed and selected parameters were measured. Results. Significantly longer QT and QTc intervals and lower QRS voltage were found in patients with alcoholic and HCV cirrhosis compared to the controls. Significantly lower QRS voltage was found in subjects with ascites than in those without ascites. Removal of ascites significantly increased QRS voltage. Conclusions. In cirrhosis, irrespective of etiology, ECG changes involved prolonged QT and QTc intervals and reduced QRS voltage. Prolonged QT and QTc intervals were not related to the severity of cirrhosis or to the presence of ascites. However, low QRS voltage was associated with the presence of ascites. Removal of ascites reverses low QRS voltage (Adv Clin Exp Med 2015, 24, 4, 615-622).

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confidence: 99%

QT Interval Prolongation and QRS Voltage Reduction in Patients with Liver Cirrhosis

Cichoż‐Lach¹,

Tomaszewski²,

Kowalik³

et al. 2015

Adv Clin Exp Med

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“…5 The management of the open abdomen is extremely challenging; early problems include infection and ongoing fluid losses, while fistulae and ventral hernias can lead to long-term complications. 6 There is, therefore, an understandable reluctance amongst surgeons to perform this procedure. The majority of intensivists would recommend surgical decompression when the IAP exceeds 25mmHg and there is organ dysfunction (64.4%, n=67).…”

Section: Discussionmentioning

confidence: 99%

Bogota Bag in Abdominal Compartment Syndrome at Kathmandu Model Hospital

Joshi

Koirala

Upadhyaya

et al. 2017

J Nepal Health Res Council

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Background:The gold standard of quick and definitive treatment of Abdominal compartment syndrome (ACS) is surgical decompression by opening the abdomen and leaving it open until intra-abdominal pressure decreases. Temporary abdominal closure techniques are used to postpone definite closure until predisposing factors causing pathologic elevation of intra-abdominal pressure are resolved.This study aim to analyze feasibility of Bogota Bag placement as a way of temporary abdominal closure. Methods:Cases admitted in the period of eight years that were diagnosed to have or at risk to develop ACS and managed with 'Bogota Bag', irrespective of primary diagnosis were reviewed retrospectively. Cause of ACS, reasons to place Bogota bag, its complications and final outcome in terms of mortality related or not related with Bogota Bag placement were assessed. Results:Total of ten patients had placement of Bogota Bag in the period of eight years. Laparotomy for bowel perforation with peritonitis was the most common primary condition contributing to ACS. Bogota bag was placed in two cases after emergency decompression as a therapeutic measure whereas others were done as prophylactic measure. There were two mortalities (20%) which were not directly related to abdominal compartment syndrome. Conclusions:Abdomen closure with Bogota Bag for patients with ACS or likely to develop ACS is a feasible technique with minimal procedure related morbidities.

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“…IAP is transmitted to the thoracic cavity directly or indirectly thought deviation of the diaphragm. The upward movement of the diaphragm causes reduction of chest wall and lung compliance, increasing intrapleural pressure, decrease of ventilation and increase of pulmonary vascular resistance [10][11][12][13]. The main respiratory problem in IAH patients is the development of compression atelectasis of the lung parenchyma, mainly in the caudal parts near diaphragm, caused by its elevation [14].…”

Section: Introductionmentioning

confidence: 99%

“…The main respiratory problem in IAH patients is the development of compression atelectasis of the lung parenchyma, mainly in the caudal parts near diaphragm, caused by its elevation [14]. As a result, all static and dynamic lung volumes are decreased [12,[15][16][17]. Adequate ventilation may only be achieved byincreased airway pressure.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Effects of Elevated Intra-abdominal Pressure on the Respiratory Mechanics in Mechanically Ventilated Patients

et al. 2013

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Aim: The aim of the study was to evaluate the effect of different grades of increased intraabdominal hypertension (IAH) on the respiratory mechanics. Material and Methods:In this prospective observational clinical study, the influence of intaabdominal pressure (IAP) on respiratory parameters was assessed in 20 patients requiring mechanical ventilation with IAH grade I, 20 patients with IAH grade II, and 20 patients with grade III IAH. Respiratory parameters were measured and recorded by a computerized system incorporated into the mechanical ventilator.Results: A statistical difference was noticed between IAP and the dynamic respiratory parameters among the groups. Regarding the respiratory parameters positive correlation between the IAP on one hand, and peak airway pressure and resistance on the other hand was notable: IAP increased and so did pressures and the resistance in the respiratory pathways. Also the correlation between IAP, on one hand and the compliance and peripheral saturation with oxygen on the other hand, was negative. Referring the mean pulmonary pressure there wasn't correlation among IAP and mean pulmonary pressure in the groups. Conclusion:IAP leads to impairment of the respiratory mechanics. An increase of the level of IAP is followed by an increase in the altering effects upon the respiratory system.

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Intra-abdominal hypertension and the abdominal compartment syndrome

Abstract: The optimal time for intervention is not known, but outcome is often poor, even after decompression. Most of the available information relates to victims of trauma rather than general surgical patients.

Cited by 115 publications

References 68 publications

QT Interval Prolongation and QRS Voltage Reduction in Patients with Liver Cirrhosis

QT Interval Prolongation and QRS Voltage Reduction in Patients with Liver Cirrhosis

Bogota Bag in Abdominal Compartment Syndrome at Kathmandu Model Hospital

Evaluation of the Effects of Elevated Intra-abdominal Pressure on the Respiratory Mechanics in Mechanically Ventilated Patients

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