The gastro-renal effects of intra-abdominal hypertension: Implications for critical care nurses

Gray, Sherree; Christensen, Martin; Craft, Judy

doi:10.1016/j.iccn.2018.06.001

Cited by 8 publications

(7 citation statements)

References 32 publications

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“…Intra-abdominal pressure (IAP) arises due to interactions between contents within the abdominal cavity and mechanical properties of the abdominal wall [1,2], and strongly correlates to intravesical pressure [3]. It is most often estimated as the pressure in a urinary bladder catheter after the evacuation of all urine and instillation of 25cc saline at end-expiration [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Once IAP reaches values equal to or greater than 12 mmHg, which is consistent with intra-abdominal hypertension (IAH), the abdominal venous system is compressed, leading to a systemic decrease in venous return and a reduced cardiac preload and output. Largest reductions in blood flow have been reported at the level of the renal and mesenteric arteries [1]. Reduced renal arterial perfusion causes a lower glomerular filtration rate and activation of the juxtaglomerular apparatus and the renin-angiotensin system.…”

Section: Introductionmentioning

confidence: 99%

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Increased Intra-Abdominal Pressure During Laparoscopic Pneumoperitoneum Enhances Albuminuria via Renal Venous Congestion, Illustrating Pathophysiological Aspects of High Output Preeclampsia

Dreesen

Schoutteten

Velde

et al. 2020

JCM

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Intra-abdominal hypertension (IAH) causes severe organ dysfunction. Our aim is to evaluate the effect of increased intra-abdominal pressure (IAP) on renal function, hypothesizing that venous congestion may increase proteinuria and fluid retention without endothelial dysfunction. Three urine samples were collected from 32 non-pregnant women undergoing laparoscopic-assisted vaginal hysterectomy (LAVH) and from 10 controls placed in Trendelenburg position for 60 min. Urine sampling was done before (PRE), during or immediately after (PER), and two hours after (POST) the procedure. Urinary albumin, protein and creatinine concentrations were measured in each sample, and ratios were calculated and compared within and between groups. During LAVH, the albumin/creatinine ratio (ACR) increased and persisted POST-procedure, which was not observed in controls. A positive correlation existed between the LAVH duration and the relative change in both ACR and protein/creatinine ratio (PCR) PER- and POST-procedure. Iatrogenic IAH increases urinary ACR and PCR in non-pregnant women via a process of venous congestion. This mechanism might explain the presentation of one specific subtype of late-onset preeclampsia, where no drop of maternal cardiac output is observed.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Increased Intra-Abdominal Pressure During Laparoscopic Pneumoperitoneum Enhances Albuminuria via Renal Venous Congestion, Illustrating Pathophysiological Aspects of High Output Preeclampsia

Dreesen

Schoutteten

Velde

et al. 2020

JCM

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“…In general, IAH may be induced by any of several intraabdominal or extra-abdominal conditions, reduced abdominal wall compliance, or intra-abdominal pathologies (of either the peritoneal space or parenchymatous organs); its mechanism is mucosal and submucosal tissue hypoperfusion, which causes considerable damage to the intestinal cells, potentially resulting in bacterial translocation, endotoxin release, or sepsis [11,12]. Among these, most commonly, intra-abdominal infections and/ or sepsis and severe trauma or burns are predisposed to lead to IAH [12].…”

Section: Discussionmentioning

confidence: 99%

“…Among these, most commonly, intra-abdominal infections and/ or sepsis and severe trauma or burns are predisposed to lead to IAH [12]. IAH is caused by decreased perfusion of the kidneys, abdominal viscera, splanchnic organs, central nervous system, and possible difficulties with ventilation and maintenance of cardiac output, and can lead to multiple-organ dysfunction [11,13,14]. IAH can be classified as either primary or secondary, and those causes are shown in Table 1 [15].…”

Section: Discussionmentioning

confidence: 99%

Abdominal compartment syndrome due to extremely elongated sigmoid colon and rectum plus fecal impaction caused by disuse syndrome and diabetic neuropathy: a case report and review of the literature

et al. 2020

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Background Abdominal compartment syndrome (ACS) is defined as a sustained raised level of intra-abdominal pressure more than 20 mmHg with or without abdominal perfusion pressure less than 60 mmHg and the development of new end-organ failure. Abdominal surgery, major trauma, volvulus, ileus, distended abdomen, fecal impaction, acute pancreatitis, liver dysfunction, sepsis, shock, obesity, and age have all been reported as risk factors. Herein, we report the severest known case of ACS due to extremely elongated sigmoid colon and rectum plus fecal impaction caused by disuse syndrome and diabetic neuropathy, together with a brief review of the literature. Case presentation A 48-year-old Asian man suffering from shock was transported by ambulance to our hospital. His medical history included hypoglycemic encephalopathy sequelae, disuse syndrome, type 2 diabetic neuropathy, and constipation. He recovered consciousness in the ambulance, and his physical examination as well as laboratory findings were normal. X-ray and dynamic computed tomography revealed a thickened gut wall, and an extremely dilated sigmoid colon and rectum filled with a massive amount of stool as well as gas, compressing other intra-abdominal organs. We diagnosed the patient with transient vasovagal syncope, together with ACS, due to extremely elongated sigmoid colon and rectum plus fecal impaction, caused by anorectal disturbance derived from disuse syndrome and diabetic neuropathy. We first repeated stool extraction for bowel decompression and he subsequently became symptom-free, after which we performed a colostomy on the 28th hospital day. The postoperative course was uncomplicated, and he was discharged on the 44th hospital day. Conclusions Clinicians need to keep ACS in mind as a differential diagnosis and perform careful and detailed examination when encountering patients presenting with symptoms or risk factors of ACS. In addition, they need to precisely diagnose ACS and perform optimal treatment without delay.

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“…К сожалению, на данный момент не установлена линейная зависимость между повышением ВБД и снижением эластичности брюшной стенки по мере увеличения интраабдоминального объема [9]. ВБД возникает из-за взаимодействия между содержимым внутри брюшной полости и механическими свойствами брюшной стенки, и сильно коррелирует с внутрипузырным давлением [13,14,15]. Рост ВБД способствует снижению перфузионного давления в абдоминальной полости, а затем снижается кровоснабжение органов и сосудов в брюшной полости или около нее [15].…”

Section: №2(42) 2020unclassified

Intraabdominal Hypertension Syndrome: Current State of the Problem

Самарцев

Гаврилов

Pushkarev

2020

jour

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Syndrome of intra-abdominal hypertension (SIAH) is a dangerous complication that can occur in patients with a surgical profile after surgery in the abdominal cavity. Only in the past 25 years has the SIAH been recognized. According to W. Ertel et al., In one third of patients with peritonitis, pancreatic necrosis, injuries of the abdominal cavity and after extensive surgery, there is an increase in intra-abdominal pressure (IAP), while SIAH develops in 5.5% of such patients. Mortality in SIAH is 42–68%. The reason for the development of so many deaths is the presence of diagnostic, preventive and therapeutic measures, as well as differences in the interpretation of terms. Today, much attention is paid to the study of SIAH, official attempts are being made to standardize and define terms and recommended methods of treatment, but this problem needs further study. The review presents data on the current state of the problem, current trends in the diagnosis, prevention and treatment of patients with IAP and SIAH, their use in practical research.

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The gastro-renal effects of intra-abdominal hypertension: Implications for critical care nurses

Cited by 8 publications

References 32 publications

Increased Intra-Abdominal Pressure During Laparoscopic Pneumoperitoneum Enhances Albuminuria via Renal Venous Congestion, Illustrating Pathophysiological Aspects of High Output Preeclampsia

Increased Intra-Abdominal Pressure During Laparoscopic Pneumoperitoneum Enhances Albuminuria via Renal Venous Congestion, Illustrating Pathophysiological Aspects of High Output Preeclampsia

Abdominal compartment syndrome due to extremely elongated sigmoid colon and rectum plus fecal impaction caused by disuse syndrome and diabetic neuropathy: a case report and review of the literature

Intraabdominal Hypertension Syndrome: Current State of the Problem

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