A new technique of direct intra-abdominal pressure measurement: A preliminary study

Risin, Elena; Kessel, Boris; Ashkenazi, Itamar; Lieberman, Noah; Alfici, Ricardo

doi:10.1016/j.amjsurg.2005.07.038

Cited by 25 publications

(17 citation statements)

References 12 publications

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“…1,3,7,[13][14][15][16] This transient increase in IAP can result in respiratory compromise (increased pCO 2 , decreased pO 2 , increased inspiratory pressures), cardiovascular compromise (decreased cardiac output, increased central venous pressure, increased pulmonary capillary wedge pressure) and renal compromise eventually leading to oliguria. 2,3,5,8,10,11,17 If ACS is left untreated or is not appropriately managed, the patient is likely to develop multi-organ system failure, 2,10,12 which currently carries a 100% mortality rate. 5,6,16 When ACS is treated with decompressive laparotomy mortality rates still vary between 40 and 68%.…”

Section: Discussionmentioning

confidence: 99%

“…1 Our study revealed that 69% of burn physicians do not routinely measure bladder pressure and only 53% measure the bladder pressure if the abdomen is tight. It is well documented that early detection of increasing IAP can assist in diagnosing IAH 4,7,16,17 while potentially avoiding ACS, a strategy that would decrease morbidity and mortality in severely burned patients. Several studies also recommend routine bladder pressure monitoring in patients at high risk for developing IAH and ACS.…”

Section: Discussionmentioning

confidence: 99%

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Defining Intra-Abdominal Hypertension and Abdominal Compartment Syndrome in Acute Thermal Injury: A Multicenter Survey

Burke

Latenser

2008

Journal of Burn Care & Research

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The definitions of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are not uniform despite the increasing awareness of IAH/ACS in burn patients. A short survey including definitions, resuscitation protocols, and monitoring practices was sent to every physician listed in the American Burn Association Directory. Thirty-two of 123 (26%) surveys were returned; 22 (69%) were from verified burn centers. Survey respondents said that bladder pressure indicating IAH is 19.6 mm Hg (range 12-30) and ACS is 25.9 mm Hg (range 15-40). Fifteen percentage of those responding do not include clinical sequellae in their definition of ACS. Bladder pressure is not routinely measured by 22 (69%) burn physicians, and staff at 17 centers (53%) wait until the abdomen is tense to measure abdominal pressure. Tense abdomen, along with elevated peak inspiratory pressures (PIP), is used in most centers (94%) to determine IAH/ACS, followed by oliguria (88%), and difficulty ventilating (78%). Resuscitation formulae used are primarily the Parkland/modified Parkland in 24 (75%) burn centers. Criteria for abdominal decompression is based on bladder pressures alone in 25 centers (78%); 16/32 (50%) use PIP, and 10/32 (31%) staff use other criteria including organ dysfunction or increased lactate. Eleven physicians (34%) advocate percutaneous decompression before decompressive laparotomy. Although most United States burn physicians define ACS as >or=25 mm Hg along with physiologic compromise, bladder pressure is routinely measured by only 31% of burn physicians. Most burn staff do not differentiate between IAH and ACS. Consensus definitions of IAH/ACS are necessary for burn care practitioners to compare research studies and discuss outcomes. Concise definitions will promote understanding of the pathophysiological processes involved and allow us to develop data-driven patient care protocols.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Defining Intra-Abdominal Hypertension and Abdominal Compartment Syndrome in Acute Thermal Injury: A Multicenter Survey

Burke

Latenser

2008

Journal of Burn Care & Research

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“…The use of abdominal drains for postoperative direct IAP measurement has recently been reported by Risin et al [19]. In this study, 14 Fr polyvinyl chloride drains were connected to a pressure transducer, and IAP values obtained directly correlated well with transvesical-measured IAP.…”

Section: Direct Iap Measurementmentioning

confidence: 98%

Current insights in intra-abdominal hypertension and abdominal compartment syndrome: open the abdomen and keep it open!

laet

Ravyts

Vidts

et al. 2008

Langenbecks Arch Surg

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The ACS was first described in surgical patients with abdominal trauma, bleeding, or infection, but in recent years ACS has also been described in patients with other pathologies such as burn injury and sepsis. Some of these so-called nonsurgical patients will require surgery to treat their ACS. This review article is intended to provide surgeons with a clear insight into the current state of knowledge regarding IAH, ACS, and the impact of IAP on the critically ill patient.

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“…However, since numerous published investigations have demonstrated a strong positive correlation of transvesicular pressure with intraperitoneal catheter measured pressures, we used only transvesicular pressure trends in our SICU. 2,6,[17][18][19] A second study limitation may result from the relatively low number of patients that had significant IAP elevations. This would require a much larger study as elevated IAP and ACS are aggressively corrected in our SICU.…”

Section: -Specificitymentioning

confidence: 99%

A Comparison of Infusion Volumes in the Measurement of Intra-Abdominal Pressure.

Kimball

Baraghoshi

Morris

et al. 2005

Critical Care Medicine

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A new technique of direct intra-abdominal pressure measurement: A preliminary study

Cited by 25 publications

References 12 publications

Defining Intra-Abdominal Hypertension and Abdominal Compartment Syndrome in Acute Thermal Injury: A Multicenter Survey

Defining Intra-Abdominal Hypertension and Abdominal Compartment Syndrome in Acute Thermal Injury: A Multicenter Survey

Current insights in intra-abdominal hypertension and abdominal compartment syndrome: open the abdomen and keep it open!

A Comparison of Infusion Volumes in the Measurement of Intra-Abdominal Pressure.

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