Beneficial effects of theophylline infusions in surgical patients with intra-abdominal hypertension

Bodnár, Zsolt; Szentkereszty, Zoltán; Hajdu, Zoltán; Boissonneault, Gilbert A.; Sipka, Sándor

doi:10.1007/s00423-011-0808-5

Cited by 14 publications

(9 citation statements)

References 35 publications

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“…The use of theophylline by counteracting adenosine binding to adenosine receptors has been shown to improve renal function, splanchnic perfusion, and cardiac contractility. The authors concluded that theophylline infusions improved IAH-related mortality in surgical patients by possibly reducing circulating adenosine concentrations [40]. Future studies are warranted to confirm these findings.…”

Section: Theophylline Infusionmentioning

confidence: 89%

What’s new in medical management strategies for raised intra-abdominal pressure: evacuating intra-abdominal contents, improving abdominal wall compliance, pharmacotherapy, and continuous negative extra-abdominal pressure

Keulenaer¹,

Regli²,

Laet³

et al. 2014

Anaesthesiol Intensive Ther

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In the future, medical management may play an increasingly important role in the prevention and management of intra-abdominal hypertension (IAH). A review of different databases was used (PubMed, MEDLINE and EMBASE) with the search terms 'Intra-abdominal Pressure' (IAP), 'IAH' , ' Abdominal Compartment Syndrome' (ACS), 'medical management' and 'non-surgical management' . We also reviewed all papers with the search terms 'IAH' , 'IAP' and 'ACS' over the last three years, only extracting those papers which showed a novel approach in the non-surgical management of IAH and ACS. IAH and ACS are associated with increased morbidity and mortality. Non-surgical management is an important treatment option in critically ill patients with raised IAP. There are five medical treatment options to be considered to reduce IAP: 1) improvement of abdominal wall compliance; 2) evacuation of intra-luminal contents; 3) evacuation of abdominal fluid collections; 4) optimisation of fluid administration; and 5) optimisation of systemic and regional perfusion. This paper will review the first three treatment arms of the WSACS algorithm: abdominal wall compliance; evacuation of intra-luminal contents and evacuation of abdominal fluid collections. Emerging medical treatments will be analysed and finally some alternative specific treatments will be assessed. Other treatment options with regard to optimising fluid administration and systemic and regional perfusion will be described elsewhere, and are beyond the scope of this review. Medical management of critically ill patients with raised IAP should be instigated early to prevent further organ dysfunction and to avoid progression to ACS. Many treatment options are available and are often part of routine daily management in the ICU (nasogastric, rectal tube, prokinetics, enema, sedation, body position). Some of the newer treatments are very promising options in specific patient populations with raised IAP. Future studies are warranted to confirm some of these findings.

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Section: Theophylline Infusionmentioning

confidence: 89%

What’s new in medical management strategies for raised intra-abdominal pressure: evacuating intra-abdominal contents, improving abdominal wall compliance, pharmacotherapy, and continuous negative extra-abdominal pressure

Keulenaer¹,

Regli²,

Laet³

et al. 2014

Anaesthesiol Intensive Ther

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Section: Discussionmentioning

confidence: 99%

“…Besides the pathophysiological changes in each organ there is also a crucial role of cell abnormalities among which the most important is hypoxia due to the elevated IAP, leading to a significant increase of serum adenosine level [2,3]. During the last few years it was confirmed by numerous studies that hypoxia, trauma and inflammation are trigger factors of adenosine production [2,3,[28][29][30][31]. Above all, the idea to study the role that adenosine potentially plays in conditions of increased intra-abdominal pressure was provided by previous adenosinerelated experience of the researchers of our working group [2,3,32].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, monitoring of serum adenosine and IL-10 concentrations may offer significant insights into the progression and treatment of IAP, particularly in patient populations at risk of IAH and ACS. The role of adenosine in the pathomechanism of IAH-ACS offers a new insight into this severe clinical syndrome [2,3,18,19].…”

Section: Serum Adenosine and Intra-abdominal Pressurementioning

confidence: 99%

“…Eventually, after being scientifically proven and re-proven and supported by "clinical leaders" and widely published in reputable journals, it is accepted as "truth" [1]. Now is widely accepted that intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are frequent findings among severely ill surgical patients [2,3]. Severe pancreatitis, inflammatory processes, retroperitoneal haemorrhage, bowel obstruction, ascites, overresuscitation, blunt abdominal trauma, peritonitis, or even massive transfusion can be found among the triggering factors of IAH and ACS.…”

Section: Introductionmentioning

confidence: 99%

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Polycompartment syndrome – intra-abdominal pressure measurement

Bodnár

2019

ait

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Intra-abdominal hypertension and the abdominal compartment syndrome are wellknown, serious, life-threatening clinical entities in acute care surgery. A common characteristic of these syndromes is the permanent and irreversible damage that may affect the organs which can be found inside the given compartment if quick intervention cannot be provided. All factors which may and can lead to a sudden increase in the intra-abdominal pressure can be found among the triggering factors of abdominal compartment syndrome. Despite the modern and quick diagnostics, and the adequate surgical interventions performed in time, the mortality of this syndrome is extremely high (38-71%). It affects practically all vital organ systems: cardiovascular, respiratory, urinary and central nervous system. There are four major compartments in the human body: the head, the chest, the abdomen and the extremities. When two or more compartments have elevated pressures the name of the clinical entity is polycompartment syndrome, first described in 2007. The only possible way of establishing the diagnosis is to measure the intra-abdominal pressure, a widespread manner of which is the measurement through the bladder. Treatment of abdominal and polycompartment syndrome is nearly always surgical decompression with temporary abdominal wall closure or open abdominal treatment. Clinicians need to be aware of the real existence of polycompartment syndrome and the complex and constant interplay of raised pressure between compartments. This highlights the importance of research and development of new intra-abdominal pressure measurement techniques.

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Intestinaler Crosstalk

Druml

2018

Med Klin Intensivmed Notfmed

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Beneficial effects of theophylline infusions in surgical patients with intra-abdominal hypertension

Cited by 14 publications

References 35 publications

What’s new in medical management strategies for raised intra-abdominal pressure: evacuating intra-abdominal contents, improving abdominal wall compliance, pharmacotherapy, and continuous negative extra-abdominal pressure

What’s new in medical management strategies for raised intra-abdominal pressure: evacuating intra-abdominal contents, improving abdominal wall compliance, pharmacotherapy, and continuous negative extra-abdominal pressure

Polycompartment syndrome – intra-abdominal pressure measurement

Intestinaler Crosstalk

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