Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. I. Definitions

Malbrain, Manu L N G; Cheatham, Michael L.; Kirkpatrick, Andrew W.; Sugrue, Michael; Parr, Michael; Waele, Jan De; Balogh, Zsolt J.; Leppäniemi, Ari; Olvera, Claudia; Ivatury, Rao R.; D’Amours, Scott; Wendon, Julia; Hillman, Ken; Johansson, K.-A.; Kolkman, Karel A.; Wilmer, Aleksander

doi:10.1007/s00134-006-0349-5

Cited by 1,285 publications

(1,207 citation statements)

References 89 publications

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“…The following definitions were used: AP diagnosed by at least two of the following three criteria – upper abdominal pain, amylase or lipase levels raised at least threefold with respect to laboratory upper limits of normal, appropriate imaging findings; organ failure – RAC and DBC definitions, adapted to intensive care, using SEMICYUC consensus conference criteria3; shock – systolic arterial pressure below 90 mmHg or a reduction of 40 mmHg in basal systolic arterial pressure, with tissue hypoperfusion signs where lactate concentration was greater than 3 mmol/l and central venous oxygen saturation was less than 70 per cent19; respiratory failure – either basal arterial partial pressure of oxygen ( P a o 2 ) below 60 mmHg, or P a o 2 or fraction of inspired oxygen ( F i o 2 ) of less than 300 mmHg with supplementary oxygen; acute renal failure – increase in serum creatinine to more than twice the upper limit of normal and/or less than 0·5 ml per kg per h for more than 12 h according to urinary output criteria for the Acute Kidney Injury Network (AKIN) classification; IAH – a repeated pathological IAP increase of 12 mmHg or above; and ACS – when IAP was above 20 mmHg with or without an abdominal perfusion pressure below 60 mmHg and associated with an organ failure that was cardiovascular, respiratory or renal1, 20.…”

Section: Methodsmentioning

confidence: 99%

“…IAP was measured via the urinary bladder at end expiration in the completely supine position after ensuring that abdominal muscle contractions were absent and with the transducer zeroed at the level of the mid‐axillary line, according to the updated consensus definition from the World Society of the Abdominal Compartment Syndrome1, 20. IAP was measured every 6 h daily, and maximum IAP value obtained during the ICU stay was the one analysed.…”

Section: Methodsmentioning

confidence: 99%

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Relationship between intra-abdominal hypertension, outcome and the revised Atlanta and determinant-based classifications in acute pancreatitis

et al. 2017

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BackgroundThe aim of this study was to analyse the relationship between intra‐abdominal hypertension (IAH) and severity of acute pancreatitis (AP) measured by the revised Atlanta classification (RAC) and determinant‐based classification (DBC). Secondary objectives were to assess IAH as a predictor of morbidity and mortality in the ICU.MethodsThis prospective international observational study included patients admitted to the ICU with AP and at least one organ failure. Information was collected on demographics, severity scores at admission using RAC and DBC, organ failure, mechanical ventilation, continuous renal replacement therapy (CRRT), surgery and mortality. Maximum intra‐abdominal pressure (IAP) during ICU stay was used for analysis.ResultsSome 374 patients were included. The hospital mortality rate was 28·9 per cent. IAP was measured in 301 patients (80·5 per cent), of whom 274 (91·0 per cent) had IAH and 103 (34·2 per cent) acute compartment syndrome. A higher IAH grade was more likely in patients with severe AP (42 per cent for grade I versus 84 per cent for grade IV) and acute critical pancreatitis (9 versus 25 per cent; P = 0·001). Compared with grade I IAH, patients with grade IV had more infected necrosis (16 versus 28 per cent; P = 0·005), need for surgery (27 versus 50 per cent; P = 0·006), mechanical ventilation (53 versus 84 per cent; P = 0·007) and requirement for CRRT (22 versus 66 per cent; P < 0·001). IAH predicted shock (area under receiver operating characteristic (ROC) curve (AUC) 0·79, 95 per cent c.i. 0·73 to 0·84), respiratory failure (AUC 0·82, 0·77 to 0·87), renal failure (AUC 0·93, 0·89 to 0·96) and mortality (AUC 0·89, 0·86 to 0·93).ConclusionIAH was associated with severity of AP classified according to both RAC and DBC systems. IAP grade can predict outcome of AP during ICU stay.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Relationship between intra-abdominal hypertension, outcome and the revised Atlanta and determinant-based classifications in acute pancreatitis

et al. 2017

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“…(2) In some patients, it may be related to increased intra-abdominal pressure (IAP). (8)(9) IAP increase reduces lung compliance; increases pleural and intrathoracic pressure, and may cause edema and atelectasis. Patients presenting intra-abdominal hypertension syndrome may require a higher positive end expiratory pressure (PEEP) to offset the effects of increased IAP.…”

Section: Mechanical Causesmentioning

confidence: 99%

Constipação intestinal em terapia intensiva

Azevedo¹,

Freitas²,

Ferreira³

et al. 2009

Rev. bras. ter. intensiva

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“…Clinical examination is not an accurate method to estimate IAP [2]. Intravesicular pressure is a good estimate for IAP, is easily measured, and should be monitored in all patients believed to be at risk for significant elevations in IAP [3][4][5][6].…”

Section: Introduction and Contextmentioning

confidence: 99%

The Abdominal Compartment Syndrome

Malbrain

Cheatham

Sugrue

et al. 2010

Surgical Intensive Care Medicine

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The abdominal compartment syndrome (ACS) was first described in surgical patients with abdominal aortic aneurysm repair, trauma, bleeding, or infection, but in recent years it has also been described in patients with other pathologies such as burn injury and sepsis and in medical patients. This F1000 Medicine Report is intended to provide critical care physicians a clear insight into the current state of knowledge regarding intra-abdominal hypertension (IAH) and ACS, and will focus primarily on the recent literature as well as on the definitions and recommendations published by the World Society of the Abdominal Compartment Syndrome. The definitions regarding increased intraabdominal pressure (IAP) will be listed, followed by a brief but comprehensive overview of the different mechanisms of organ dysfunction associated with IAH. The gold standard measurement technique for IAP as well as recommendations for organ function support in patients with IAH and options for medical and surgical treatment of IAH and ACS will be discussed.

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Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. I. Definitions

Cited by 1,285 publications

References 89 publications

Relationship between intra-abdominal hypertension, outcome and the revised Atlanta and determinant-based classifications in acute pancreatitis

Relationship between intra-abdominal hypertension, outcome and the revised Atlanta and determinant-based classifications in acute pancreatitis

Constipação intestinal em terapia intensiva

The Abdominal Compartment Syndrome

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