Microdialysis of the rectus abdominis muscle for early detection of impending abdominal compartment syndrome

Meier, Christoph; Contaldo, Claudio; Schramm, René; Holstein, Joerg H.; Hamacher, Juerg; Amon, M.; Wanner, Guido A.; Trentz, O.; Menger, Michael D.

doi:10.1007/s00134-007-0725-9

Cited by 22 publications

(15 citation statements)

References 41 publications

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“…This observation may provide new perspectives regarding IAH monitoring. With the RAM being easily accessible by surgical or even percutaneous means, not only pressure monitoring but also functional monitoring of the RAM, such as microdialysis, may provide superior and earlier perceptions of critical IAH [4].…”

Section: Discussionmentioning

confidence: 99%

“…This finding may be of clinical relevance, because CPRS measurement may be an alternative method when other techniques are not feasible. Furthermore, a subsequent experimental study using a rodent model revealed that functional monitoring of the rectus abdominis muscle, which lies within the rectus sheath, may be a far more subtle indicator of critical IAH than IAP measurement alone [4]. Therefore, it was the aim of the study presented herein to validate the analysis of CPRS in a more clinically relevant porcine model.…”

Section: Introductionmentioning

confidence: 95%

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Compartment Pressure of the Rectus Sheath Accurately Reflects Intra-Abdominal Pressure in a Porcine Model

Benninger

Laschke

Cardell

et al. 2010

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Compartment Pressure of the Rectus Sheath Accurately Reflects Intra-Abdominal Pressure in a Porcine Model

Benninger

Laschke

Cardell

et al. 2010

Journal of Surgical Research

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“…Recent findings revealed that changes in abdominal tissue metabolism, assessed via microdialysis , may occur well before the development of IAH-related organ dysfunction [70,71].…”

Section: Effects Of Iah On Tissue Perfusion and Microcirculationmentioning

confidence: 99%

Abdominal pressure and gastrointestinal function: an inseparable couple?

Blaser¹,

Malbrain²,

Regli³

2017

Anaesthesiol Intensive Ther

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Evaluating the degree of organ dysfunction is a cornerstone in distinguishing patients with critical illness from those without. However, evaluation of the gastrointestinal function in critically ill patients is not unified, and is still largely based on subjective clinical evaluation. Although intra-abdominal pressure has been proposed as a parameter to facilitate monitoring of abdominal compartment in critical illness, the interactions between intra-abdominal pressure and gastrointestinal function are poorly clarified. The aim of this current review is to describe interactions and associations between gastrointestinal dysfunction and intra-abdominal pressure from a pathophysiological and clinical point of view.

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“…Additionally, they reported persistent respiratory acidosis even after decompression, reductions in renal blood flow and urine output and lung damage [26]. Meier et al observed that a similar IAP level led to haemodynamic deterioration and organ dysfunction, with parenchymal injury in the liver, lung, bowel and myocardium [27].…”

Section: Impact Of Intra-abdominal Hypertension On the Liver Kidneysmentioning

confidence: 99%

Early impact of abdominal compartment syndrome on liver, kidney and lung damage in a rodent model

Lima¹,

Silva²,

Capelozzi³

et al. 2017

Anaesthesiol Intensive Ther

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Background: Abdominal compartment syndrome (ACS) sometimes occurs in critically ill patients following damage control surgery. The purpose of the present study was to develop a model of ACS and to evaluate its pathologic impact on liver, kidney, and lung morphology. Methods: Twenty Wistar rats (mass 300-350 g) were randomly divided into four groups: 1) intra-abdominal hypertension (IAH): a laparotomy was performed and the abdomen packed with cotton until an intra-abdominal pressure (IAP) of 15 mm Hg was reached; 2) hypovolemia (HYPO): blood was withdrawn until a mean arterial pressure ~60 mm Hg was reached; 3) IAH + HYPO (to resemble clinical ACS); and 4) sham surgery. After 3 hours of protective mechanical ventilation, the animals were euthanized and the liver, kidney and lungs removed to examine the degree of tissue damage. Results: IAH resulted in the following: oedema and neutrophil infiltration in the kidney; necrosis, congestion, and microsteatosis in the liver; and alveolar collapse, haemorrhage, interstitial oedema, and neutrophil infiltration in the lungs. Furthermore, IAH was associated with greater cell apoptosis in the kidney, liver and lungs compared to sham surgery. HYPO led to oedema and neutrophil infiltration in the kidney. The combination of IAH and HYPO resulted in all the aforementioned changes in lung, kidney and liver tissue, as well as exacerbation of the inflammatory process in the kidney and liver and kidney cell necrosis and apoptosis. Conclusions: Intra-abdominal hypertension by itself is associated with kidney, liver and lung damage; when combined with hypovolemia, it leads to further impairment and organ damage.

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Microdialysis of the rectus abdominis muscle for early detection of impending abdominal compartment syndrome

Abstract: Our data suggest that continuous microdialysis in the RAM may represent a promising tool for early detecting IAH-induced metabolic derangements.

Cited by 22 publications

References 41 publications

Compartment Pressure of the Rectus Sheath Accurately Reflects Intra-Abdominal Pressure in a Porcine Model

Compartment Pressure of the Rectus Sheath Accurately Reflects Intra-Abdominal Pressure in a Porcine Model

Abdominal pressure and gastrointestinal function: an inseparable couple?

Early impact of abdominal compartment syndrome on liver, kidney and lung damage in a rodent model

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