Intra-abdominal pressure: Time ripe to revise management guidelines of acute pancreatitis?

Jaipuria, Jiten; Bhandari, Vasundhra; Chawla, Ashish; Singh, Mohit

doi:10.4291/wjgp.v7.i1.186

Cited by 35 publications

(32 citation statements)

References 81 publications

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“…Eight rabbits, weighing a median of 3.59 kg (range, 3.30-3.85 kg), were used for the cross-over experiments. New bacterial growth in urine after OCD for 10 h was observed in five of the eight rabbits using DSnB catheters with check valves (specimens 3,4,5,7,8) and also in five of those without check valves (specimens 2, 3, 5, 6, 8), respectively. No significant difference was apparent (P = 1.000; Table 1).…”

Section: Bacterial Influx (In Vivo)mentioning

confidence: 93%

“…The forceps at the end of the DSnB catheter were removed, and the saline was allowed to drain from the bladder. Changes in intravesical pressure and time were continuously recorded until pressure reached 5 cmH 2 O or 20 min elapsed from the start of timing.…”

Section: Methodsmentioning

confidence: 99%

“…At the start of the experiment, saline was continuously infused into the bladder through the infusion site of the cystometry catheter until the intravesical pressure reached 20 cmH 2 O. 8 The forceps at the end of the DSnB catheter were removed, and the saline was allowed to drain from the bladder. Changes in intravesical pressure and time were continuously recorded until pressure reached 5 cmH 2 O 8-10 or 20 min elapsed from the start of timing.…”

Section: Intravesical Pressure Reduction (In Vitro)mentioning

confidence: 99%

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Validity of a disposable catheter to drain urine overnight in neurogenic bladder

Furukawa

Ishikawa

Tsuchiya

et al. 2019

Pediatrics International

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Background Overnight catheter drainage (OCD) is introduced to avoid overdistention of the bladder at night‐time when clean intermittent catheterization proves ineffective for daytime management of neurogenic bladder. We adopted OCD using disposable silicone no‐balloon (DSnB) catheters, with the distal end outside the body opening into diapers. OCD using DSnB catheter, however, had risks of retrograde bacterial contamination. Therefore, in this study, the validity of equipping DSnB catheters with check valves to prevent retrograde bacterial contamination was examined. Methods For the in vitro study, excised saline‐filled swine bladders were drained using DSnB catheters with or without check valves, and the time required for intravesical pressure to reach 5 cmH2O was measured. For the in vivo study, in cross‐over experiments comparing DSnB catheters with and without check valves, OCD using DSnB catheters for 10 h was performed in rabbits under analgesia. Bacterial growth from urine samples before and after OCD and residual urine volume were examined. Results For the in vitro experiment, the median drainage time was 368.2 s (range, 88–1,085 s) and 344.7 s (range, 28–840 s) with and without check valves, respectively (n = 6), which was not significantly different. For the in vivo experiment, in cross‐over experiments (n = 8) new bacterial growth rates after OCD did not differ, and median residual urine volume was 17.1 mL (range, 0–75 mL) and 1.2 mL (range, 0–5 mL) with and without check valves, respectively (P = 0.055). Conclusions Installing a check valve in the DSnB catheter did not decrease new bacterial growth, while tending to increase residual urine volume. DSnB catheters without check valves appear to be better for continuous drainage of urine from bladder.

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Section: Bacterial Influx (In Vivo)mentioning

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Section: Intravesical Pressure Reduction (In Vitro)mentioning

confidence: 99%

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Validity of a disposable catheter to drain urine overnight in neurogenic bladder

Furukawa

Ishikawa

Tsuchiya

et al. 2019

Pediatrics International

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“…The presence of hypotension, tachycardia, hypoxemia, and oliguria for >48 h indicates persistent organ failure, and if the patient does not respond with adequate IV fluid therapy, management in ICU might be required which probably involves gastroenterology or general surgery [6]. The physical examination must be repeated every 4-8 h, for monitoring the alteration in the mental state and/or abdominal stiffness which would indicate the presence of fluid in the third space or abdominal compartment syndrome [70,71]. In the first 6-12 h, complete metabolic panel, complete blood count, serum levels of calcium, magnesium, glucose, and BUN, should be performed as required according to the patient's condition.…”

Section: Treatmentmentioning

confidence: 99%

Review of Current Evidence in Acute Pancreatitis

Varley¹,

Rossi²,

Murray³

et al. 2019

obm hg

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Acute pancreatitis (AP), an inflammatory condition of the pancreas, is one of the most common ailments of the gastrointestinal system, which results in significant morbidity and mortality. The main etiological causes of AP include alcohol consumption, gallstones, hypertriglyceridemia, and biliary stones. The clinical signs and symptoms of AP and the diagnostic criteria for this disease have been well established. Multiple scoring systems are applied to predict the severity and prognosis of AP, and the associated mortality. The present review of the literature highlights the recent significant contributions in the areas of etiology, risk factors, epidemiology, diagnosis, complications, prognosis, and the latest modalities in the treatment, which could be beneficial in the management of AP.

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“…The pathophysiology of ACS is considered to be directly associated with the pancreas inflammation, which initiates a cascade of acute peripancreatic fluid collections (APFC), capillary leakage syndrome (CLS), and paralytic ileus leading to an elevated IAP [4,5]. Several studies describing the effect of various interventions to lower IAP in SAP patients with both medical and surgical measures have been published in recent years [6,7].…”

Section: Introductionmentioning

confidence: 99%

Early Continuous Veno-Venous Hemofiltration Is Effective in Decreasing Intra-Abdominal Pressure and Serum Interleukin-8 Level in Severe Acute Pancreatitis Patients with Abdominal Compartment Syndrome

Ying

Tian³

2017

Blood Purif

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Objective: The aim of this study was to evaluate the efficacy of early continuous veno-venous hemofiltration (CVVH) in decreasing the intra-abdominal pressure (IAP) and serum interleukin-8 (IL-8) level in severe acute pancreatitis (SAP) patients with abdominal compartment syndrome (ACS). Methods: Twenty-five ACS patients of SAP were enrolled in a prospective study conducted according to the standard management protocol. They were treated in the intensive care unit (ICU) of Affiliated Yidu Central Hospital of Weifang Medical College and underwent CVVH. Eleven patients were set up as the control group that received no hemofiltration and surgical treatment due to economic or other reasons but solely conventional treatment. Serum amylase, liver and kidney function, and C reactive protein were investigated before and after treatment. IAP and blood level of IL-8 were measured daily to investigate their time course of changes and the correlation between the 2 parameters. Results: Serum amylase levels, C-reactive protein and IAP were significantly lower and liver and kidney function was significantly better than those of the control group (p < 0.05). IAP on admission to the ICU was high, at 22.9 ± 2.1 mm Hg. The IAP was significantly lower to 17.2 ± 2.2 mm Hg (p < 0.01) 24 h after the initiation of CVVH, and thereafter decreased rapidly. The average blood level of IL-8 was high at 88.2 ± 25.1 ng/L on admission. However, it significantly decreased to 63.2 ± 18.7 ng/L (p < 0.01) 24 h after the initiation of CVVH, and subsequently decreased. There was a significant positive correlation between the blood level of IL-8 and IAP(r = 0.62, p < 0.01). Conclusions: CVVH is effective to decrease the IAP and the blood level of IL-8 in ACS patients of SAP. The blood level of IL-8 was significantly correlated with IAP, suggesting that IL-8 might play an important role in the pathogenesis of ACS. Early CVVH appeared to be effective in the treatment of ACS in patients with SAP through the removal of causative cytokines such as IL-8, and it thereby decreased interstitial edema to lower IAP and should be applied in the early stage of ACS. Video Journal Club ‘Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=480223.

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Intra-abdominal pressure: Time ripe to revise management guidelines of acute pancreatitis?

Abstract: We suggest that IAP be given its due place in future practice guidelines and that recommendations be formed with help of a broader panel with inclusion of clinicians experienced in management of IAH.

Cited by 35 publications

References 81 publications

Validity of a disposable catheter to drain urine overnight in neurogenic bladder

Validity of a disposable catheter to drain urine overnight in neurogenic bladder

Review of Current Evidence in Acute Pancreatitis

Early Continuous Veno-Venous Hemofiltration Is Effective in Decreasing Intra-Abdominal Pressure and Serum Interleukin-8 Level in Severe Acute Pancreatitis Patients with Abdominal Compartment Syndrome

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