Intra-abdominal pressure may be decreased non-invasively by continuous negative extra-abdominal pressure (NEXAP)

Abstract

Negative extra-abdominal pressure may be applied in critically ill patients to decrease intra-abdominal pressure non-invasively.

Reactive hyperemia in the human liver

“…Hepatic hyperemia was observed during the recovery period after a 15-min 40 mmHg LBNP maneuver in young healthy men in a relaxed supine position. We used the ICG disappearance method to assess hepatic perfusion (8,40) during and following LBNP (17,39). It has been shown that the hepatic extraction of ICG dye remains constant throughout LBNP (33), supporting our approach.…”

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 WSACS has provided a list with risk factors associated with IAH and ACS ( When measured in the head of the bed (HOB) elevated Figure 22. Examples of practical and bedside external application devices to lower IAP and/or IAV; A -The ABDOPRE, a device that can be used for lowering IAP by using a bell [118]; B -The bell to be applied on the abdomen in which a negative pressure or vacuum can be generated [120]; C -the application of NEXAP on the abdomen in an animal study [124]; D -The so-called sarcophage, a medical device that can generate continuous NEXAP, in which a patient is placed in toto [152]; E -cuirass placed on the abdomen in a patient [122]; F -the application of a cuirass placed upside down on the abdomen, normally to be put on the thorax for negative pressure ventilation [125] to 30° and 45°, the IAP on average is respectively 4 and 9 mm Hg higher [131]. This effect is more pronounced in patients with higher BMI [7].…”

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

“…Regarding the cardiovascular function, heart rate and MAP remained unchanged in most [110] Neuromuscular blockade [35,98,[111][112][113] Body positioning [114][115][116] Negative fluid balance Weight loss Evacuation of intraluminal contents Gastric tube and suctioning 117] Gastroprokinetics (erythromycin, cisapride, metoclopramide) [85,87,118] Rectal tube and enemas [81][82][83]117] Colonoprokinetics (neostigmine, prostigmine bolus, or infusion) [84,86,88] Endoscopic decompression of large bowel Colostomy Ileostomy Evacuation of peri-intestinal and abdominal fluids Ascites evacuation in cirrhosis [89][90][91][92][93]119] Percutaneous drainage of abscess or hematoma Removal of free intraperitoneal blood Correction of capillary leak and positive fluid balance Albumin in combination with diuretics (furosemide) [43,99,120] Correction of capillary leak (antibiotics, source control,...) Colloids instead of crystalloids [101,121] Dialysis or CVVH with ultrafiltration [102,103,122] Specific therapeutic interventions Continuous negative abdominal pressure [123,124]. Targeted abdominal perfusion pressure Negative external abdominal pressure [125][126][127].…”