The value of intra-abdominal pressure monitoring through transvesical route in the choice and outcome of management of congenital abdominal wall defects

Elsaied, Adham; Medhat, None Sherif; Sheir, Hesham; Aly, Kamal

doi:10.1097/01.xps.0000511425.39279.13

Cited by 4 publications

(5 citation statements)

References 15 publications

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“…In Ferdous et al, three of their patients (15%) died as they could not provide NICU support for all their patients in the form of available prolonged parenteral nutrition (38). According to Elsaied et al and Shehata et al, the death rate was among patients for whom primary abdominal closure was done, which is low in comparison with the mortality percentage reported in patients repaired with silo (34,39).…”

Section: Discussionmentioning

confidence: 98%

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High Abdominal Perfusion Pressure Using Umbilical Cord Flap in the Management of Gastroschisis

et al. 2021

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Background: Gastroschisis management remains a controversy. Most surgeons prefer reduction and fascial closure. Others advise staged reduction to avoid a sudden rise in intra-abdominal pressure (IAP). This study aims to evaluate the feasibility of using the umbilical cord as a flap (without skin on the top) for tension-free repair of gastroschisis.Methods: In a prospective study of neonates with gastroschisis repaired between January 2018 to October 2020 in Tanta University Hospital, we used the umbilical cord as a flap after the evacuation of all its blood vessels and suturing the edges of the cord with the skin edges of the defect. They were guided by monitoring abdominal perfusion pressure (APP), peak inspiratory pressure (PIP), central venous pressure (CVP), and urine output during 24 and 48 h postoperatively. The umbilical cord flap is used for tension-free closure of gastroschisis if PIP > 24 mmHg, IAP > 20 cmH2O (15 mmHg), APP <50 mmHg, and CVP > 15cmH2O.Results: In 20 cases that had gastroschisis with a median age of 24 h, we applied the umbilical cord flap in all cases and then purse string (Prolene Zero) with daily tightening till complete closure in seven cases, secondary suturing after 10 days in four cases, and leaving skin creeping until complete closure in nine cases. During the trials of closure, the range of APP was 49–52 mmHg. The range of IAP (IVP) was 15–20 cmH2O (11–15 mmHg), the range of PIP was 22–25 cmH2O, the range of CVP was 13–15 cmH2O, and the range of urine output was 1–1.5 ml/kg/h.Conclusion: The umbilical cord flap is an easy, feasible, and cheap method for tension-free closure of gastroschisis with limiting the PIP ≤ 24 mmHg, IAP ≤ 20 cmH2O (15 mmHg), APP > 50 mmHg, and CVP ≤ 15cmH2O.

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Section: Discussionmentioning

confidence: 98%

“…They observed that IAP values measured intraoperatively correlate significantly with both APP and PIP measured at the same time. Therefore, these parameters also can predict postoperative IAH/ACS ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

High Abdominal Perfusion Pressure Using Umbilical Cord Flap in the Management of Gastroschisis

et al. 2021

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“…An intra-abdominal pressure of less than 20 mm of water will allow a direct closure [8,22]. Intra-abdominal pressure should be also monitored the days following the intervention in order to early diagnose the onset of postoperative abdominal compartment syndrome [8,22]. In our case, intestinal transit was restored 6 days after surgery and postoperative intra-abdominal pressure was normal.…”

Section: Discussionmentioning

confidence: 73%

“…e feasibility of a primary closure is established postnatally by the measurement of intra-abdominal pressure, which must be monitored during the intervention to avoid abdominal compartment syndrome. An intra-abdominal pressure of less than 20 mm of water will allow a direct closure [8,22]. Intra-abdominal pressure should be also monitored the days following the intervention in order to early diagnose the onset of postoperative abdominal compartment syndrome [8,22].…”

Section: Discussionmentioning

confidence: 99%

Giant Isolated Omphalocele: Role of Prenatal Diagnosis in Prognostic Asessment and Perinatal Management

Cubo

Alcalde

Gastaca

et al. 2020

Case Reports in Medicine

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Omphalocele is a congenital malformation of the abdominal wall consisting of a protrusion of the abdominal contents at the base of the umbilical cord. It has a high association with genetic and structural defects; however, if the latter is ruled out, its prognosis improves significantly. Prenatal diagnosis has a key role in this condition as omphalocele can be diagnosed by ultrasound in the first trimester scan, enabling a coordinated approach strategy to achieve the best perinatal results. We present a case report of a pregnant patient with a fetus having a giant omphalocele in which prenatal diagnosis played a decisive role, allowing the coordination of a multidisciplinary team, which was crucial in the immediate care of the newborn.

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“…The design of IAP-measuring sensors has been modified for different target patients. For open-abdomen or postoperative patients, the direct peritoneal sensor is relatively easy to insert, whether in adult or pediatric patients [ 67 , 68 ]. However, for patients without surgical intervention or those who are critical, the insertion of a direct peritoneal catheter will increase the possibility of peritoneal viscus injuries.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Diagnostic Sensors for Intra-Abdominal Pressure Monitoring

Liao

Cheng

Chen

et al. 2021

Sensors

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Intra-abdominal pressure (IAP) is defined as the steady-state pressure within the abdominal cavity. Elevated IAP has been implicated in many medical complications. This article reviews the current state-of-the-art in innovative sensors for the measurement of IAP. A systematic review was conducted on studies on the development and application of IAP sensors. Publications from 2010 to 2021 were identified by performing structured searches in databases, review articles, and major textbooks. Sixteen studies were eligible for the final systematic review. Of the 16 articles that describe the measurement of IAP, there were 5 in vitro studies (31.3%), 7 in vivo studies (43.7%), and 4 human trials (25.0%). In addition, with the advancement of wireless communication technology, an increasing number of wireless sensing systems have been developed. Among the studies in this review, five presented wireless sensing systems (31.3%) to monitor IAP. In this systematic review, we present recent developments in different types of intra-abdominal pressure sensors and discuss their inherent advantages due to their small size, remote monitoring, and multiplexing.

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The value of intra-abdominal pressure monitoring through transvesical route in the choice and outcome of management of congenital abdominal wall defects

Cited by 4 publications

References 15 publications

High Abdominal Perfusion Pressure Using Umbilical Cord Flap in the Management of Gastroschisis

High Abdominal Perfusion Pressure Using Umbilical Cord Flap in the Management of Gastroschisis

Giant Isolated Omphalocele: Role of Prenatal Diagnosis in Prognostic Asessment and Perinatal Management

Systematic Review of Diagnostic Sensors for Intra-Abdominal Pressure Monitoring

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