Intra-abdominal Pressure in the Morbidly Obese

Lambert, David M.; Marceau, Simon; Forse, R. Armour

doi:10.1381/096089205774512546

Cited by 289 publications

(200 citation statements)

References 26 publications

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“…• Male gender • Old age (loss of elastic recoil) [17] • Obesity (weight, BMI) [78−80] • Android composition (sphere, apple shape) [15,20,78,79] • Increased visceral fat • Waist-to-hip ratio > 1 • Short stature…”

Section: A Related To Anthropomorphy and Demographicsmentioning

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

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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: A Related To Anthropomorphy and Demographicsmentioning

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

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“…5,28 because of diaphragmatic contraction and relaxation 3,33 (Table 2). Higher body mass index is correlated with higher IAP in adults, 6,34 but not in children. 35 Body position also affects IAP.…”

Section: Iap Measurementsmentioning

confidence: 82%

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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“…Feasibility, time consumption and acquisition circumstances for TTE in MO were beyond the scope of this article, but were assessed recently in our previous study (8). It is possible that increased intra-abdominal pressures (IAP) in MO may have affected the results (26,33), and intra-abdominal pressures were not measured or controlled. Commonly occurring (in severe obesity) increased liver size (liver steatosis) in combination with increased intra-abdominal pressure may have an effect on inferior vena cava size and the venous return of the heart.…”

Section: Discussionmentioning

confidence: 99%

Morbid Obesity and Optimization of Preoperative Fluid Therapy

et al. 2013

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Morbid obesity and optimization of preoperative fluid therapy. AbstractContext: Preoperative venous return (VR) optimization and adequate blood volume is essential in management of morbidly obese patients (MO) in order to avoid perioperative circulatory instability. In this study, all subjects underwent a preoperative three-week preparation by rapid-weight-loss-diet (RWL) as part of their treatment program for bariatric surgery. Design: Prospective, observational study. Setting: Sunderby County Hospital, Luleå, Sweden. Subjects: Thirty-four morbidly obese patients consecutively scheduled for bariatric surgery. Interventions: Preoperative transthoracic echocardiography (TTE) was performed in the awake state before and after intravascular volume-challenge (VC) of 6 ml colloids/kg ideal body weight (IBW). Effects of standardized VC were evaluated by TTE. Dynamic and nondynamic echocardiographic indices for VC were studied. Main outcome measures: Volume-responsiveness and level of VR before and after VC were assessed by TTE. An increase of stroke volume (Δ SV) ≥ 13% was considered as a volumeresponder. Results: 29/34 patients were volume-responders. After VC, a majority of patients (23/34) were euvolemic, and only 2/34 were hypovolemic. Post VC hypervolemia was observed in 9/34 of patients. Conclusions: The IBW-based volume challenge regimen was found to be suitable for preoperative rehydration of RWL-prepared MO. Most of the patients were volumeresponders. Preoperative state of VR was not associated with volume-responsiveness. IBWestimates and appropriate monitoring avoids potential hyperhydration in MO. For VC assessment, conventional Doppler indices were found to be more suitable compared to tissue Doppler, giving sufficient information on pressure-volume correlation of the left ventricle in morbidly obese.

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Intra-abdominal Pressure in the Morbidly Obese

Cited by 289 publications

References 26 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

Abdominal Compartment Syndrome in Children

Morbid Obesity and Optimization of Preoperative Fluid Therapy

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