Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage

Chen, Hong; Li, Fēi; Sun, Jiayi; Jia, Jianguo

doi:10.3748/wjg.14.3541

Cited by 122 publications

(148 citation statements)

References 36 publications

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“…Diferentes modelos experimentais foram avaliados com o intuito de caracterizar o risco de desenvolvimento de hipertensão intra-abdominal e/ou síndrome de compartimento abdominal (Biancofiore et al 2002, Hong et al 2002, Chen et al 2008 , Cheatham et al 2007.…”

Section: Discussionunclassified

Pressão intra-abdominal em cães

Gonçalves¹,

Wouk

Mira³

2011

Pesq. Vet. Bras.

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812Pesq. Vet. Bras. 31(9):812-816, setembro 2011 RESUMO.-Sob consenso recente em pacientes humanos, os valores basais da pressão intra-abdominal (PIA) e seus prováveis limiares em casos mórbidos, foram estipulados com intuito de favorecer a homogeneidade de estudos científicos, além de fornecer diretrizes para conduta diagnóstica e terapêutica destes pacientes. Valores basais e alterações na pressão intra-abdominal em animais não são ainda suficientemente conhecidos e cientificamente determinados. Médicos veterinários necessitam conhecer melhor os estados mórbidos que cursam com Hipertensão Intra-Abdominal (HIA) ou Sín-drome de Compartimento Abdominal (SCA). O presente estudo objetivou testar em cães a técnica já descrita sob consenso na medicina como modelo de mensuração da pressão intra-abdominal, assim como determinar os valores normais para a espécie. Foram utilizados 15 cães hígidos, machos e fêmeas, homogêneos e todos sem raça definida. A mensuração da pressão intra-abdominal foi realizada por meio da téc-nica indireta de sondagem vesical e utilização de coluna de água com régua graduada em cm de H 2 O, sendo seu valor final convertido para a unidade de mm de Hg. In order to favor the homogeneity of scientific studies and to provide guidelines on the diagnosis and therapy, human basal values of the intra-abdominal pressure (IAP) and their probable thresholds in morbid cases were recently established. However, basal values and changes in the intra-abdominal pressure in animals are still partly unknown and not scientifically confirmed. Veterinarians have the need to expand their knowledge on morbid conditions that develop with Intra-Abdominal Hypertension (IAH) or Abdominal Compartment Syndrome (ACS). The present study aims to test in dogs the technique adopted in human medicine as a model for measurement of intra-abdominal pressure (1) and determine normal values for the species (2). Fifteen known mongrel healthy dogs, males and females and homogenous were tested. The measurement of IAP was done through an indirect technique which involves catheterizing the bladder and using a water column with a graduate ruler in cm of H 2 0 -its final value converted to mm of Hg. The values observed ranged from a minimum sub atmospheric value (below of zero mm of Hg) to 3,75 mmHg. There was a considerable variation within the individual values observed in some animals, bringing up considerations related to body mass, frequency/total volume of the physiologic solution to be administered and inquietude of these dogs during the treatment. The thresholds values found are considered physiologic, indicating reliability of the technique and possibility of its clinical use. The absence of sedation and the use of urethral catheter did not compromised the measurement, however could have resulted in under-or overestimation of the values found.

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Section: Discussionunclassified

Pressão intra-abdominal em cães

Gonçalves¹,

Wouk

Mira³

2011

Pesq. Vet. Bras.

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“…IAH and ACS are common events in acute pancreatitis (AP), affecting up to 60–80 per cent of patients in some studies4, 5. The proportion of patients thought to have IAH depends on where the threshold is set.…”

Section: Introductionmentioning

confidence: 99%

“…With an IAP greater than 15 mmHg, over 75 per cent of patients might be classified as having IAH4, 5, often within the first 12 h of their apparent illness6, 7. Some patients with AP may develop ACS (25–56 per cent)4, 5, 6, 7, 8, associated with a high mortality rate (50–75 per cent)4, 5, 6, 7, 8. IAH in AP with organ failure is generally thought to reflect visceral oedema due to the severity of the inflammatory process, potentially compounded by aggressive fluid resuscitation (volume overload).…”

Section: Introductionmentioning

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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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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“…He explained that a tight bandage obstructs the blood supply to the extremity, which results in severe pain at rest and the eventual loss of viability of the extremity, leading to amputation. This description is an early explanation of compartment syndrome (a condition that involves an increased pressure in a confined anatomical space and adversely affects blood circulation) eight centuries before the work of Richard von Volkmann (1830-1889) who explained compartment syndrome in 1881 [7,10,11] . Taken as a whole, Avicenna's discourses on bone fractures, dislocations and related issues establish his knowledge and contributions to the advancement of the science of orthopedics.…”

Section: To the Editormentioning

confidence: 99%